Management of stress urinary incontinence in female patients with spinal cord injury by autologous fascial sling: time for a revival?

Pannek, Jürgen; Wöllner, Jens (2022). Management of stress urinary incontinence in female patients with spinal cord injury by autologous fascial sling: time for a revival? Spinal cord series and cases, 8(1), p. 57. Springer Nature 10.1038/s41394-022-00524-8

[img] Text
s41394-022-00524-8.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (334kB)

STUDY DESIGN

This study is a retrospective chart analysis.

OBJECTIVES

Surgical treatment of stress urinary incontinence (SUI) in women with neurogenic lower urinary tract dysfunction (NLUTD) is a challenge, as minimally invasive procedures do not seem to be effective, whereas synthetic implants are associated with substantial risks. Thus, we evaluated the results of an autologous sling procedure in this group of patients SETTING: This study was performed at a spinal cord injury rehabilitation center in Switzerland.

METHODS

In this retrospective analysis, we evaluated the objective, subjective, and urodynamic results in women undergoing autologous sling insertion for SUI due to NLUTD at our institution.

RESULTS

The data of 17 women who underwent fascial sling surgery were analyzed. After a median follow-up of 40 months, 8 women (47%) were continent, and another 8 patients (47%) significantly improved (1 pad/day). Median video-urodynamic parameters remained unchanged after sling insertion, but two women developed de novo detrusor overactivity. Postoperative complications occurred in 6 of the 17 patients (35.3%), which required surgical interventions in 2 women (12%) (urethral erosion by the sling and complete occlusion of the urethra after removal of the catheter), which could be resolved without loss of continence.

CONCLUSION

In our case series, autologous fascial slings were effective in the treatment of SUI in women with NLUTD. As they are more effective than minimally invasive procedures, are associated with fewer complications than AUS, and seem to omit possible severe long-term consequences of synthetic slings, they are an excellent treatment option in this group of patients. Urodynamic controls are recommended, as de novo detrusor overactivity may occur after sling insertion.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Pannek, Jürgen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2058-6124

Publisher:

Springer Nature

Language:

English

Submitter:

Pubmed Import

Date Deposited:

27 May 2022 08:21

Last Modified:

05 Dec 2022 16:20

Publisher DOI:

10.1038/s41394-022-00524-8

PubMed ID:

35610208

BORIS DOI:

10.48350/170279

URI:

https://boris.unibe.ch/id/eprint/170279

Actions (login required)

Edit item Edit item
Provide Feedback