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. 2011 Mar;52(3):184-8.
doi: 10.4111/kju.2011.52.3.184. Epub 2011 Mar 18.

How to achieve long-term success in the treatment of female urinary stress incontinence? Novel modification on vaginal sling

Mahmoud Mustafa  1
Affiliations

How to achieve long-term success in the treatment of female urinary stress incontinence? Novel modification on vaginal sling

Mahmoud Mustafa. Korean J Urol. 2011 Mar.

Abstract

Purpose: Modest long-term success is one of the most disappointing issues facing patients undergoing anti-incontinence surgery. Herein we introduce a novel surgical modification of the vaginal sling to address the mechanisms that may lead to a reduction in the success rate at the long-term follow-up.

Materials and methods: Twenty-three female patients with mean age of 48.2 years (range, 22-73 years) underwent anti-incontinence surgery to correct their stress urinary incontinence (SUI) between August 2006 and January 2008. The in situ anterior vaginal wall sling, reinforced with equi-size monofilament polypropylene tape, was used as an anti-incontinence surgical procedure. The mean follow-up period was 30.2 months (range, 24-38 months).

Results: The surgical technique was successful in 22 patients (95.65%); 20 of them were cured and 2 patients showed clinical improvements. Urinary retention was observed in one patient (4.34%), which was resolved after decreasing the tension of the suspension sutures. No significant post-voiding residue was detected postoperatively.

Conclusions: Cost-effectiveness and a low risk of urethral erosion, due to the presence of intervening vaginal mucosa, are important advantages of this technique. Long-term success is expected, because relaxation of the non-tension-free suspension sutures and dislocation of the midurethral sling are less likely.

Keywords: In situ vaginal sling; Incontinence; Urinary incontinence, stress.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

FIG. 1
FIG. 1
Schematic illustration of the placard-shaped incision made at the anterior vaginal wall before starting dissection.
FIG. 2
FIG. 2
In situ sling prepared from the anterior vaginal wall.
FIG. 3
FIG. 3
Polypropylene mesh of similar size to the in situ sling with two lateral suspension sutures.
See this image and copyright information in PMC

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