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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

References

    1. Elving LB, Foldspang A, Lam GW, Mommsen S. Descriptive epidemiology of urinary incontinence in 3,100 women age 30-59. Scand J Urol Nephrol Suppl. 1989;125:37–43. - PubMed
    1. Diokno AC, Brock BM, Brown MB, Herzog AR. Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly. J Urol. 1986;136:1022–1025. - PubMed
    1. Nygaard IE, Heit M. Stress urinary incontinence. Obstet Gynecol. 2004;104:607–620. - PubMed
    1. Liapis A, Bakas P, Creatsas G. Burch colposuspension and tension-free vaginal tape in the management of stress urinary incontinence in women. Eur Urol. 2002;41:469–473. - PubMed
    1. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996;7:81–85. - PubMed