RE: PUBOVAGINAL SLING WITH A LOW-COST POLYPROPYLENE MESH
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FRANSBER R. RODRIGUES, ROMULO MAROCCOLO FILHO, ROBERTO R. MAROCCOLO, LUCIO C. PAIVA, FERNANDO A. DIAZ, EDUARDO C. RIBEIRO

Service of Urology, Brasilia University Hospital, Brasilia, DF, Brazil

Int Braz J Urol, 33: 690-694, 2007

To the Editor:

     The authors are commended on a nice review of their experience with the distal urethral polypropylene sling, which may provide a low-cost alternative to some of the new midurethral polypropylene sling techniques. This technique, which is often referred to as DUPS by the original authors, was first described by Rodriguez & Raz in 2003 (1). Subsequent reports of the UCLA experience with DUPS have ensued, with a recent long-term, report with follow up in excess of five years.
     The study design is retrospective with mean follow up of 42 months (range 14-61). The success of the procedures is notable with adequate minimum follow up for current standards. The conclusions reached by these authors are very similar to those made in the original Rodriquez & Raz paper (1). Although no particularly new facts are presented in this manuscript, it is encouraging to see confirmation of the experience of the original group. Long term follow up by the original group has also proven satisfactory (2), and it would be ideal to have further follow-up of the present cohort to validate this data.
     Finally, in this era of cost-consciousness, it behooves us all to consider technical and material options that may preserve successful outcomes, while providing economic advantages. The authors are congratulated on a fine confirmatory report.

REFERENCES

1. Rodriguez LV, Raz S: Prospective analysis of patients treated with a distal urethral polypropylene sling for symptoms of stress urinary incontinence: surgical outcome and satisfaction determined by patent driven questionnaires. J Urol. 2003; 170: 857-63.
2. Rutman M, Itano N, Deng D, Raz S, Rodriguez LV: Long-term durability of the distal urethral polypropylene sling procedure for stress urinary incontinence: minimum 5-year follow up of surgical outcome and satisfaction determined by patient reported questionnaires. J Urol. 2006; 175: 610-3.

Dr. Kathleen C. Kobashi
Co-Director, Continence Center at Virginia
Virginia Mason Medical Center
Seattle, Washington, USA
E-mail: urokck@vmmc.org