The Autologous Fascial Pubovaginal Sling for Recurrent Stress Incontinence: A Retrospective Study

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Surgery

Background:

• Recurrent stress urinary incontinence (SUI) poses a significant challenge, particularly after initial treatments like mid-urethral sling procedures fail.
• Salvage surgical options are crucial for managing persistent SUI and improving patients' quality of life.

Purpose of the Study:

• To evaluate the clinical efficacy and safety of autologous fascial pubovaginal sling (AFPVS) surgery.
• To assess AFPVS as a salvage treatment for recurrent SUI following failed mid-urethral sling procedures.

Main Methods:

• Retrospective analysis of SUI patients who underwent AFPVS after mid-urethral sling failure (June 2008-June 2024).
• Inclusion of basic information, surgical parameters, and postoperative complications.
• 6-month follow-up using International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) and Incontinence Quality of Life Questionnaire (I-QOL).

Main Results:

• Overall effectiveness rate of 82.3% (20 cured, 8 improved) in 34 patients.
• Significant reduction in ICI-Q-SF scores (p < 0.001) and increase in I-QOL scores (p < 0.001) post-surgery.
• Minor complications included 3 cases of bladder injury, resolving with catheterization; no intraoperative urethral or vaginal injuries.

Conclusions:

• Autologous fascial pubovaginal sling (AFPVS) is a safe and effective salvage procedure.
• AFPVS offers a viable solution for recurrent SUI after mid-urethral sling failure.