An Inexpensive Polypropylene Patch Sling for Treatment of Intrinsic Sphincteric Deficiency

Study ObjectiveTo evaluate an inexpensive polypropylene sling in patients with intrinsic sphincteric deficiency (ISD).DesignCase series (Canadian Task Force classification II-2).SettingCleveland Clinic Florida teaching hospital.PatientsAnalysis of 161 patients with ISD who underwent a surgeon-assembled polypropylene (Prolene) patch sling procedure.InterventionPolypropylene patch sling surgery was performed in all study patients with urinary stress incontinence due to ISD.Measurements and Main ResultsAll 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.ConclusionUse of a polypropylene patch sling is an effective treatment for ISD and is less expensive than currently available sling kits.