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• W2098045153 abstract "Objective To assess the use of silastic sling for genuine stress incontinence. Design Retrospective descriptive analysis. Setting Tertiary referral centre for urogynaecology. Subjects Eighty-eight women with urodynamically proven genuine stress incontinence, 10 had coexistent detrusor instability. In 74 women, the sling operation was for recurrent incontinence. Intervention A low Pfannenstiel incision was used and a suburethral tunnel dissected to insert the sling, which was attached under minimal tension with non-absorbable sutures to each ileopectineal ligament. Main outcome measures Clinical and urodynamic data were assessed between two and three months post-surgery; thereafter clinical assessment and pad testing were performed at yearly intervals for five years. Results The subjective cure at three months was 81% and the objective cure was 69 %. There was a fall in success rate with increasing number of continence operations, and this was statistically significant for women with three or more previous continence operations (P < 0.05). Neither age, parity nor menopausal status made a statistical difference to the cure rate. Twenty-three women had reached their fifth year follow up and the success rate using life table analysis was 71%. Post-operatively, 29 women had detrusor instability: 22 women developed detrusor instability de novo and seven had detrusor instability presurgery. Urodynamic findings post-surgery showed an increase (P < 0.001) in outflow resistance. Four women required removal of sling for voiding difficulties. Ten women developed sling erosions: five vaginal, four bladder erosions and one urethral erosion. After removal of the sling, seven women still remained continent. Conclusions A silastic sling operation for the treatment of genuine stress incontinence provides a good long term cure, considering that 45% of women had two or more previous failed continence operations. The high prevalence of detrusor instability and voiding difficulties post-surgery should be noted." @default.
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• W2098045153 date "1995-02-01" @default.
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• W2098045153 title "A follow up of silastic sling for genuine stress incontinence" @default.
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• W2098045153 doi "https://doi.org/10.1111/j.1471-0528.1995.tb09068.x" @default.
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