In a nutshell
This study investigated the long-term outcomes of autologous pubovaginal slings (APVS) in women with stress urinary incontinence (SUI). Researchers suggested that APVS is a durable treatment for these patients.
Some background
SUI consists of the leakage of urine due to pressure put on the bladder. This can be caused by exercise, sneezing, laughing, or coughing. SUI is present in 9.9 to 36.1% of people, being twice as high in older women or men.
APVS is considered a standard treatment with reported success rates between 80 and 90%. It consists of removing tissue from the tummy to use as a sling around the bladder and urethra (the tube that passes urine out of the bladder). The sling supports the bladder stopping the leakage of urine. Despite the improved outcomes associated with APVS, no long-term outcomes have been reported so far.
Methods & findings
This study included information about 83 women with SUI. All participants underwent APVS treatment. Of these, 34 patients had very long follow-up (average 14.5 years) based on clinic visits (7) or phone calls (27). 49 patients were lost to follow-up including 5 deaths. 18 patients had a primary APVS (group 1; first surgical treatment for SUI) and 16 had a secondary APVS (group 2; the second surgical treatment for SUI after a first treatment had failed).
Overall, 53% of participants reported a long-term successful APVS procedure. After an average follow-up of 14.5 years, 44% of patients in group 1 and 63% in group 2 reported a successful APVS procedure. No significant difference was found in urinary symptoms or quality of life between both groups or between medium and long-term follow-up.
The bottom line
This study concluded that APVS is a safe and durable treatment for women with stress urinary incontinence.
The fine print
This study did not include practical outcomes such as bladder stress tests and others. Many of the participants were lost during follow-up. Further studies are necessary with more outcomes included.
Published By :
International urogynecology journal
Date :
Mar 12, 2021