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Comparative analysis of urinary incontinence severity after autologous fascia pubovaginal sling, pubovaginal sling and tension-free vaginal tape.
J Urol. 2007 Feb; 177(2):604-8; discussion 608-9.JU

Abstract

PURPOSE

Autologous fascia, Pelvicol implant and polypropylene are common materials used in suburethral anti-incontinence procedures. We explored the relative effectiveness of the autologous fascia pubovaginal sling, Pelvicol pubovaginal sling and Gynecare TVT on self-reported postoperative urinary incontinence.

MATERIALS AND METHODS

The study was a mailed cross-sectional survey of health related quality of life 1 to 3 years after suburethral anti-incontinence surgery performed at our institution. The Incontinence Symptom Index was used to assess the presence and severity of urinary incontinence symptoms and the Incontinence Impact Questionnaire-7 was used to assess impairment. Regression models were developed to identify factors with an independent effect on the presence, severity and impairment of urinary incontinence symptoms.

RESULTS

The questionnaire was returned by 69% of eligible respondents (173 of 250). Those with previous incontinence surgery (OR 11.0, 95% CI 2.3-51.4) and medical comorbidities (OR 1.6, 95% CI 1.1-2.2) were more likely to report urinary incontinence symptoms, ie incontinence symptom index greater than 0. Symptom severity, which was analyzed only in respondents with urinary incontinence symptoms, was greater in the Pelvicol than in the autologous fascia pubovaginal sling and TVT groups (each p <0.01). No significant difference was observed between the TVT and autologous fascia pubovaginal sling groups (p = 0.15). Also associated with higher urinary incontinence symptom severity scores were body mass index (p = 0.03), a history of incontinence surgery (p = 0.01) and lower education (p <0.01). Impairment from urinary incontinence, as assessed by the Incontinence Impact Questionnaire-7, was associated with body mass index, severe depression and current smoking (each p = 0.01) but not with surgical treatment group.

CONCLUSIONS

Women who received an autologous fascia pubovaginal sling or TVT reported lower symptom severity scores than those who had a Pelvicol pubovaginal sling. Impairment was not associated with procedure type. These findings suggest better outcomes with autologous fascia pubovaginal sling and TVT. Randomized, controlled trials are needed to confirm these findings.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan 48109-0759, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17222642

Citation

Morgan, Daniel M., et al. "Comparative Analysis of Urinary Incontinence Severity After Autologous Fascia Pubovaginal Sling, Pubovaginal Sling and Tension-free Vaginal Tape." The Journal of Urology, vol. 177, no. 2, 2007, pp. 604-8; discussion 608-9.
Morgan DM, Dunn RL, Fenner DE, et al. Comparative analysis of urinary incontinence severity after autologous fascia pubovaginal sling, pubovaginal sling and tension-free vaginal tape. J Urol. 2007;177(2):604-8; discussion 608-9.
Morgan, D. M., Dunn, R. L., Fenner, D. E., Faerber, G., DeLancey, J. O., McGuire, E. J., & Wei, J. T. (2007). Comparative analysis of urinary incontinence severity after autologous fascia pubovaginal sling, pubovaginal sling and tension-free vaginal tape. The Journal of Urology, 177(2), 604-8; discussion 608-9.
Morgan DM, et al. Comparative Analysis of Urinary Incontinence Severity After Autologous Fascia Pubovaginal Sling, Pubovaginal Sling and Tension-free Vaginal Tape. J Urol. 2007;177(2):604-8; discussion 608-9. PubMed PMID: 17222642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative analysis of urinary incontinence severity after autologous fascia pubovaginal sling, pubovaginal sling and tension-free vaginal tape. AU - Morgan,Daniel M, AU - Dunn,Rodney L, AU - Fenner,Dee E, AU - Faerber,Gary, AU - DeLancey,John O L, AU - McGuire,Edward J, AU - Wei,John T, PY - 2006/04/20/received PY - 2007/1/16/pubmed PY - 2007/2/28/medline PY - 2007/1/16/entrez SP - 604-8; discussion 608-9 JF - The Journal of urology JO - J Urol VL - 177 IS - 2 N2 - PURPOSE: Autologous fascia, Pelvicol implant and polypropylene are common materials used in suburethral anti-incontinence procedures. We explored the relative effectiveness of the autologous fascia pubovaginal sling, Pelvicol pubovaginal sling and Gynecare TVT on self-reported postoperative urinary incontinence. MATERIALS AND METHODS: The study was a mailed cross-sectional survey of health related quality of life 1 to 3 years after suburethral anti-incontinence surgery performed at our institution. The Incontinence Symptom Index was used to assess the presence and severity of urinary incontinence symptoms and the Incontinence Impact Questionnaire-7 was used to assess impairment. Regression models were developed to identify factors with an independent effect on the presence, severity and impairment of urinary incontinence symptoms. RESULTS: The questionnaire was returned by 69% of eligible respondents (173 of 250). Those with previous incontinence surgery (OR 11.0, 95% CI 2.3-51.4) and medical comorbidities (OR 1.6, 95% CI 1.1-2.2) were more likely to report urinary incontinence symptoms, ie incontinence symptom index greater than 0. Symptom severity, which was analyzed only in respondents with urinary incontinence symptoms, was greater in the Pelvicol than in the autologous fascia pubovaginal sling and TVT groups (each p <0.01). No significant difference was observed between the TVT and autologous fascia pubovaginal sling groups (p = 0.15). Also associated with higher urinary incontinence symptom severity scores were body mass index (p = 0.03), a history of incontinence surgery (p = 0.01) and lower education (p <0.01). Impairment from urinary incontinence, as assessed by the Incontinence Impact Questionnaire-7, was associated with body mass index, severe depression and current smoking (each p = 0.01) but not with surgical treatment group. CONCLUSIONS: Women who received an autologous fascia pubovaginal sling or TVT reported lower symptom severity scores than those who had a Pelvicol pubovaginal sling. Impairment was not associated with procedure type. These findings suggest better outcomes with autologous fascia pubovaginal sling and TVT. Randomized, controlled trials are needed to confirm these findings. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/17222642/Comparative_analysis_of_urinary_incontinence_severity_after_autologous_fascia_pubovaginal_sling_pubovaginal_sling_and_tension_free_vaginal_tape_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2006.09.062?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -