CADAVERIC FASCIA LATA SLING FOR STRESS URINARY INCONTINENCE: A LONG-TERM QUALITY OF LIFE ANALYSIS.

HE. Richter

   Objective: The purpose of this prospective study was to describe the effects of full-length cadaveric fascia lata (CFL) sling on long-term quality of life outcomes as reflected in impact of incontinence, lower urinary tract symptomatology, and patients' perceptions of outcome and satisfaction with surgery.

   Materials and Methods: Patients were 102 women, aged 29 to 87 years (Mean = 63.1 ± 11.5), who underwent full-length CFL sling procedure for stress incontinence associated with intrinsic sphincter deficiency. They were followed for up to 48 months using a continence center patient registry and outcomes database. Outcomes were evaluated using the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), and a Patient Satisfaction Questionnaire (PSQ). Descriptive analyses were conducted to characterize outcomes and paired t tests were used to test changes from baseline.

   Results: Response rates were 87.8% at 12 months, 77.5% at 24 months, 84.0% at 36 months, and 93.3% at 48 months. Mean time from surgery was 35 months (± 12.5). IIQ scores declined from a pre-surgical mean of 55.1 to 11.0 at 12 months after surgery, indicating reduced life impact of incontinence [t = 9.8, p<. 001]. Results were maintained through the follow-up period (Means = 9.6, 11.0, 12.5; all p-values < .001). Similarly, scores on the UDI-6 declined from 67.1 before surgery to 28.0 at 12 months after surgery, indicating improvement in urinary symptoms [t = 10.1, p<. 001]. Results were maintained through the 48-month follow-up (Means = 25.8, 29.1, 28.0; all p-values <.01). On the PSQ, 79.7% of patients reported that their leakage was better or much better at the 12-month follow-up (77.4% at 24 months, 75.0% at 36 months, and 75.0% at 48 months). At 12 months, 90.2% of patients reported that they were somewhat or completely satisfied with their progress. Similar numbers re! ported satisfaction throughout the follow-up period: 89.8% at 24 months, 85.0 % at 36 months, and 85.7% at 48 months.

   Conclusion: Results indicate that the CFL sling procedure has an enduring beneficial effect on lower urinary tract symptoms and the impact of incontinence on quality of life.

   Key words: cadaveric sling, stress incontinence, outcomes