Background: Polypropylene slings have become widely used for the treatment of stress urinary incontinence (SUI): these slings provide a backboard effect for the hypermobile urethra. The purpose of this study is to look at the success of the suprapubic slings in treating those with less hypermobility in their urethral complex.
Methods: From March 2002 to March 2003, eighty four women ages 38 to 87 (mean=59) underwent suprapubic slings using the SparcTM from American Medical Systems Inc. All of these women underwent preoperative urodynamic testing and valsalva leak point pressures (VLPP). All had a Q-tip test which showed minimal hypermobility (i.e.<30 degree). This group also had abdominal leak points < 100 cm of water. The follow up ranged from 2 to 3 years (mean 2.5 years). On follow up, a supine stress test was performed and subjective assessment via a questionnaire was obtained.
Results: 65/84(77%) patients were dry, and another 6/84 (7%) wre improved. 15/84(18%) developed urgency and 1/84 (1%) was in retention. There were no significant bowel or vascular complications. 30% of the patients had concomitant vaginal surgery.
Conclusion: The suprapubic polypropylene sling can treat SUI in the setting of decreased hypermobility and low leak point pressures. However, the patients should be counseled that the success rates will not be as impressive as those with hypermobile urethras.

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