Purpose: Sling procedures have been used successfully to treat stress urinary incontinence (SUI). We report our initial experience with the use of a synthetic polypropylene mesh for treatment of SUI. Based on similar surgical principles of cadaveric fascia sling, we describe placement of a thinly woven polypropylene mesh under the distal urethra. We describe our technique and report our initial results.
Materials and methods: There were 146 consecutive patients evaluated. All patients had clinical evidence of SUI. Patients underwent preoperative evaluation with video urodynamics, symptom questionnaire, and cystoscopy. Postoperatively the patients were evaluated at 3-month intervals by symptom questionnaire, physical examination, and postvoid residuals (PVR). One year after the procedure, all patients were asked to fill out a voiding dysfunction and incontinence symptom questionnaire and a validated quality-of-life questionnaire. A flow and PVR also were obtained.
Results: Average intraoperative time was 27 minutes for the sling procedure. There were no intraoperative complications and one major postoperative complication. There was no permanent retention and no erosions. Ninety-two percent of patients had either no or rare stress incontinence. Postoperatively, 7% of patients developed de novo urge incontinence.
Conclusion: We describe excellent results with a new simple, quick, and inexpensive method to correct SUI by placing a polypropylene mesh under the distal urethra.