OUTCOMES STUDY: IS THE PUBIC BONE STABILIZATION SLING PROCEDURE FOR STRESS URINARY INCONTINENCE EQUAL TO OTHER ANTI-INCONTINENCE PROCEDURES?

Stephen H. Cruikshank, MD, MBA

   Objective: To compare the cure rates for the pubic bone stabilization sling procedure for stress urinary incontinence to the Burch procedure and abdomino-vaginal slings.

   Materials and Methods: This was a 4.5 year (January 1998 to July 2002) prospective/observational surgical study. It includes 315 patients undergoing pubic bone stabilization sling for selected indications. The statistical power assumes a going cure rate of 90.0%. We wanted to be 4.0% different. We also wanted to be 95.0% sure of the difference; therefore we needed 216 people. We had 265 patients with stress urinary incontinence. Over a 4.5 year period the pubic bone stabilization sling was performed for anatomic stress urinary incontinence (SUI= 220), stress incontinence due to intrinsic sphincter deficiency (ISD= 45), hypermobile urethra/potential stress urinary incontinence (50 patients). Not all patients underwent complex urodynamics.

   Results: For patients with SUI/ISD the cure rate for total dryness was 89.8% (238 patients). Another 9.0% described themselves as much better (24 patients) and would have had the sling performance again. Three (3) patients were no better and had to be reoperated. Various complications occurred including one case of osteomeylitis of the symphysis pubis.

   Conclusions: The pubic bone stabilization sling is equal to other highly regarded procedures used to cure SUI. Additionally, it is quick, it avoids an abdominal incision, and has minimal complications.