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An inexpensive polypropylene patch sling for treatment of intrinsic sphincteric deficiency
Beatriz Arias1, Aimee L Smith, James Raders
1Cleveland Clinic Florida, Weston, FL 33331, USA.
Study Objective:
To evaluate an inexpensive polypropylene sling in patients with intrinsic sphincteric deficiency (ISD).
Design:
Case series (Canadian Task Force classification II-2).
Setting:
Cleveland Clinic Florida teaching hospital.
Patients:
Analysis of 161 patients with ISD who underwent a surgeon-assembled polypropylene (Prolene) patch sling procedure.
Intervention:
Polypropylene patch sling surgery was performed in all study patients with urinary stress incontinence due to ISD.
Measurements And Main Results:
All patients underwent urogynecologic evaluation including multichannel urodynamics. Outcome measures included a standardized stress test, patient-reported cure rate, surgical complications, and postoperative voiding dysfunction. Medical records for the 161 patients who underwent the procedure were available for review. Mean patient age was 62.4 years. Twenty-five patients (16%) had concomitant detrusor overactivity. Mean follow-up was 3.6 years. The stress test yielded negative findings in 93.4% of patients. Complete continence was reported by 80.3% of patients, and marked improvement by 7%. The estimated cost of the sling was $17 to $272, depending on the materials used. Two patients experienced urinary retention requiring urethrolysis. Three required sling revision because of healing problems.
Conclusion:
Use of a polypropylene patch sling is an effective treatment for ISD and is less expensive than currently available sling kits.
