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Gore-Tex patch sling: 7 years later
1Division of Urology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Objectives:
To assess the long-term results of a transvaginal endoscopic Gore-Tex patch sling in women with genuine stress urinary incontinence due to urethral hypermobility and/or intrinsic sphincter deficiency, with or without coexistent urge incontinence.
Methods:
Between December 1989 and June 1994, we performed a Gore-Tex patch sling procedure in 141 consecutive women. All patients had documented stress urinary incontinence on preoperative videourodynamic testing. We conducted outcomes analysis using the information from postoperative office visits, detailed chart reviews, patient questionnaires, and telephone surveys.
Results:
A complete follow-up was available in 90 patients. The mean follow-up was 51 months (range 27 to 84). Their mean age was 54.2 years (range 32 to 86). Stress incontinence was completely cured in 80 (88.9%) of 90 patients. Pure stress incontinence persisted in 4 (4.4%) of 90 patients. Mixed incontinence occurred in 6 (6.7%) of 90 patients. Pure urge incontinence was experienced by 16 (17.8%) of 90 patients. Six patients required incision of the Gore-Tex patch for obstruction or retention; 3 remain continent. Five patients developed vaginal granulation tissue requiring Gore-Tex patch removal; 1 remains continent. There was no bladder or urethral erosion.
Conclusions:
The transvaginal Gore-Tex patch sling has provided durable efficacy with minimal morbidity for the treatment of stress urinary incontinence due to anatomic urethral hypermobility and/or intrinsic sphincter deficiency.
