An inexpensive polypropylene patch sling for treatment of intrinsic sphincteric deficiency

Study objective: To evaluate an inexpensive polypropylene sling in patients with intrinsic sphincteric deficiency (ISD).

Design: Case series (Canadian Task Force classification II-2).

Setting: Cleveland Clinic Florida teaching hospital.

Patients: Analysis of 161 patients with ISD who underwent a surgeon-assembled polypropylene (Prolene) patch sling procedure.

Intervention: Polypropylene patch sling surgery was performed in all study patients with urinary stress incontinence due to ISD.

Measurements and main results: All patients underwent urogynecologic evaluation including multichannel urodynamics. Outcome measures included a standardized stress test, patient-reported cure rate, surgical complications, and postoperative voiding dysfunction. Medical records for the 161 patients who underwent the procedure were available for review. Mean patient age was 62.4 years. Twenty-five patients (16%) had concomitant detrusor overactivity. Mean follow-up was 3.6 years. The stress test yielded negative findings in 93.4% of patients. Complete continence was reported by 80.3% of patients, and marked improvement by 7%. The estimated cost of the sling was $17 to $272, depending on the materials used. Two patients experienced urinary retention requiring urethrolysis. Three required sling revision because of healing problems.

Conclusion: Use of a polypropylene patch sling is an effective treatment for ISD and is less expensive than currently available sling kits.