Introduction

Multiple surgical procedures have been introduced for the treatment of (SUI) with variable morbidities. In this study, the results and long term follow up of fascial modified pubovaginal sling (MPVS) were evaluated.

Methods

from March 1995 to January 2016, 220 female patients complaining of SUI underwent MPVS. Preoperative evaluation included history, physical examination, and uroflow. Full urodynamics were performed in cases of mixed incontinence or recurrent cases. The patients had an average age of 45.7 years and parity 4. The presentations were pure SUI in 84 (38.2%) and mixed incontinence in 136 cases (61.8 %). MPVS (Ghoniem's modification) was performed using a 7 x 2.5 cm patch harvested from the rectus sheath with polypropylene sutures on both sides. With Stamy's needle, the sutures of the patch were guided up to the suprapubic region, and then cystoscopy was performed. The patients were followed up 3, 6, and 12 months, then annually every year up to 20 years in old cases. The patients were subdivided, according to duration of follow up, into 4 groups (I-IV) from 15- 20, 10-14, 5-9 and < 5 years respectively

Results

MPVS was performed alone in 157 (71.4%) and accompanied with cystocele and / rectocele repair in 63 cases (28.6 %). Intraoperative and postoperative complications were managed properly. After one year, 205 patients (93.2 %) cured, while 15 patients (6.8 %) failed. Follow up was lost in 20 patients for different causes. For 57 patients in group I, the success rate was reported in 53 (92.9%), 52 (91.2 %), 49 (86%) and 49 cases (86 %) after 5, 10, 15 and 20 years follow up respectively.

Conclusions

MPVS is very simple procedure without major complications. It has a satisfactory long term results and stable with time up to 20 years.

Funding

none