Porcine small intestinal submucosa implant in pubovaginal sling procedure on 48 consecutive patients: long-term results

Objective: The long-term efficacy of pubovaginal sling (PVS) procedure with porcine small intestinal submucosa (SIS) implant was retrospectively assessed. Study design: Forty-eight patients with SUI underwent a pubovaginal sling with SIS. Patient evaluation included history, physical examination with stress test and prolapse assessment by Baden-Walker classification, routine laboratory tests, 24 h-pad test, and multichannel urodynamic measurement. Postoperatively the patients were classified as cured, improved and unchanged or failed. A King's Health Questionnaire (KHQ) was performed to verify post-operatively the quality of life of these patients. Results: At median follow-up of 76 months 33/48 (69%) were cured, 6/48 (12%) were improved while 9/. 48 (19%) were failed or unchanged. No urinary retention or dyspareunia was reported and no vaginal erosion or adverse tissue reaction was detected. The descriptive statistics of KHQ scores by dimensions was done in 32/48 patients (67%). Failed or unchanged patients showed worse scores than cured and improved patients in all KHQ dimensions showing an overall overlapping between objective and subjective results although these findings are weakened due to the lack of a preoperative evaluation of QoL. Conclusions: PVS procedure using SIS cannot offer a durable option for the treatment of SUI as reported by the current mininvasive techniques. (C) 2011 Elsevier Ireland Ltd. All rights reserved.