Abstract

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• INTRODUCTION:

  Women at `high risk` for sling failure (advanced age, failed previous anti-incontinence surgery, intrinsic sphincter deficiency, and absence of urethral hypermobility) underwent acellular bovine dermis slings. We evaluate long term outcomes and complications with this material.

  MATERIALS AND METHODS:

  We retrospectively identified 41 women who completed 36 month postoperative follow up. Preoperative evaluation included pelvic exam, SEAPI classification, and validated quality of life (QoL) questionnaires. Stress urinary incontinence (SUI) cure equaled SEAPI (S) subset = 0 and negative cough-stress test. Perioperative data was abstracted from the hospital and office chart.

  RESULTS:

  The SUI cure rate was 80.5%. Most SUI recurrences occurred within the first 12 months of follow up. Perioperative complications and rates of reoperation for recurrent SUI were low. There was a postoperative improvement in mean SEAPI scores and significant improvement in all QoL indices over preoperative baseline values.

  CONCLUSIONS:

  At long term follow up, bovine dermis continues to be a durable biologic option for a population at 'high risk' for surgical failure after sling surgery. SUI-specific clinical outcomes remain stable, while rates of complications continue to be low. Improvement in QoL indices persists with long term follow up.