Long-term outcome and quality of life after modified pubovaginal sling for intrinsic sphincteric deficiency

Objectives. To evaluate the long-term outcome of the modified pubovaginal sling (MPVS) procedure and its impact on our patients' quality of life (QOL). Methods. We mailed an outcome questionnaire to 112 female patients who underwent the MPVS procedure for complicated type III stress urinary incontinence (SUI), intrinsic sphincteric deficiency. Eighty-two responses (73.2%) were obtained, with a mean follow-up of 3.4 years (range 0.5 to 8). Forty-four of them have had a follow-up for more than 3 years. Results. Of the patients who responded, 86.3% were satisfied, and 78% of the patients reported significant improvement; 49.3% were dry all the time, 21.9% were occasionally wet, 17.9% were wet with moderate activity, and 10.9% were wet all the time. Social activity improved in 74% of the patients, and sexual activity improved in 39%. No significant difference was noted in continence and satisfaction or QOL. Reviewing the charts of our failures (15 patients, 19.2%) revealed that all of them had urge incontinence with or without SUI. Conclusions. The questionnaire results revealed a high satisfaction rate and a significant improvement in the QOL of patients with complicated SUI who underwent MPVS. The patients remained satisfied over a long follow-up period. Failures are mostly associated with urge incontinence and severe irritative symptoms. (C) 1999, Elsevier Science Inc, All rights reserved.