The long-term success of abdominovaginal sling operations for genuine stress XXXX and a cystocoele--a questionnaire-based study.

@entity1 @entity6369 @entity322 @entity6684 @entity3133
Abdominovaginal sling surgery is performed in @entity1 with genuine stress @entity322 . It is not usually a primary operation because of the higher morbidity compared to the colposuspension. Slings are indicated in incontinent @entity1 with previous failed surgery, @entity6369 , intrinsic sphincter weakness, @entity3133 or those with restricted vaginal mobility. This study was undertaken to assess long-term @entity1 perceived success of abdominovaginal sling surgery in @entity1 with genuine stress @entity322 (GSI) in the presence of a cystocoele. The case notes were reviewed of all 37 @entity1 undergoing sling surgery for GSI in the presence of a significant cystocoele between 1988 and 1999. @entity1 were sent a questionnaire at a minimum follow-up of 12 months enquiring about urinary symptoms. The mean duration of follow-up was 49 months. Six weeks following surgery 33/37 (89%) were completely dry. Thirty-three @entity1 (89%) responded to the questionnaire. Of these 14/33 (42%) were totally dry, 10/33 (30%) had insignificant leakage and 9/33 required regular protection. The mean visual analogue score of improvement in @entity322 was 75.3 (+/-30.1). The operation was deemed successful in 24/33 (72%) @entity1 . Voiding difficulty was reported in 12% and recurrent prolapse occurred in 15%. Of the failures 8/9 reported urge @entity322 and 4/9 stress @entity322 . Frequency, urgency and urge @entity322 were significantly more common in the @entity1 in whom the operation failed. This study demonstrates a 72% long-term success of abdominovaginal sling operations in @entity1 with GSI and a significant cystocoele. Development of @entity6684 accounted for most of the operative failures.
