Very popular in many parts of the world, autologous fascial pubovaginal sling (AFPVS) remains marginally used in France. However, it may be of particular interest in patients carrying a high risk of mesh-related or device-related related complications. The aim of the present series was to report the outcomes of AFPVS in this high-risk population.
The charts of all female patients who underwent a fascial sling for SUI at a single academic center between April 2019 and May 2021 were reviewed retrospectively. Only patients deemed at high-risk of device/mesh related complications were included in the present analysis: female with a neurological condition who were doing clean intermittent catheterization (CIC), female with SUI after radical cystectomy and ileal neobladder, female with urethral/bladder extrusion of any synthetic material placed for SUI. Success was defined as complete resolution of SUI at 3 months.
Sixteen patients were included in this study: 13 rectus fascia slings and 3 fascia lata slings. The success rate was 56.3% (9/16 patients). Four patients were improved but not completely dry (25%). Two patients had major postoperative complications (i.e. Clavien grade 3 or higher, 11.2%). Two patients had a persisting significant post-void residual (PVR) postoperatively, managed by self-catheterization (transition to self-catheterization at 3 months: 2/8, 25%).
The use of autologous fascia pubovaginal sling is an interesting option in female SUI patients with high risk of device/mesh related complications with satisfactory functional outcomes.
4.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2022 May 16 [Epub ahead of print]
C Haudebert, C Richard, H Common, J Hascoet, I Bentellis, L Freton, C Voiry, E Samson, A Manunta, B Brucker, B Peyronnet
Service d'urologie, CHU de Rennes, Rennes, France. Electronic address: ., Service d'urologie, CHU de Rennes, Rennes, France., Service d'orthopédie, CHU de Rennes, Rennes, France., Service d'urologie, CHU de Nice, Nice, France., Service de médecine physique et réadaptation, CHU de Rennes, Rennes, France., Service d'urologie, New York University, New York, États-Unis.