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Updated: Jun 20, 2026
Transvaginal Mesh Insertion in the Ovine Model
Published on: July 27, 2017
Long-term efficacy of the pubovaginal Mersilene mesh sling
Stephen B Young1, Allison E Howard, Diego S Illanes
1Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA. youngS01@ummhc.org
Objective:
The objective of the study was to determine the efficacy of the pubovaginal Mersilene mesh sling (PVMMS) for complicated urodynamic stress incontinence (USI).
Study Design:
Between 1990 and 2008, patients with USI plus an at-risk diagnosis underwent a PVMMS by a single surgeon. They were followed up with urodynamics (UDE) and Pelvic Floor Distress Inventory-short form 20 (PFDI-20). Stratification was in an at-risk hierarchy: intrinsic sphincter deficiency (ISD) greater than recurrent USI (RUSI) greater than USI with chronically increased intraabdominal pressure (CI-IAP). A cough stress test determined objective cure. PFDI question 17 assessed subjective cure.
Results:
Three hundred six patients with ISD (43.5%), RUSI (26.8%), and CI-IAP (29.7%) had objective cure rates of 89.2% in the short term, 86.7% in the intermediate term, and 91.2% in the long term. A group of 48 patients with both short- and long-term UDEs showed cures of 100% and 91.7%. Long-term objective cure rates were: ISD, 90.5% (n = 21); RUSI, 84.2%, (n = 19); CI-IAP, 100% (n = 17). The mean score of postoperative PFDI question 17 was 0.57 (n = 119). Mean symptom improvement was -2.98 (n = 52; P < .0001).
Conclusion:
We demonstrated PVMMS to be subjectively and objectively effective in long-term treatment of complicated forms of USI.
