Incisionless per vaginal bone anchor cystourethropexy for the treatment of female stress incontinence: experience with the first 50 patients

Abstract

Purpose: We evaluated the safety and efficacy of a new minimally invasive surgical procedure for the treatment of women with genuine stress urinary incontinence.

Materials and methods: A total of 50 women (mean age 51 years) was treated for type I or II stress urinary incontinence. A miniature bone anchor and a staple like bone anchor driver were used for fixation of periurethral tissue to the public bone.

Results: The procedure was successfully performed in all patients without intraoperative bleeding. No significant persistent postoperative pain was noted and only 1 patient had urinary tract infection. Concomitant vaginal hysterectomy, cystocele repair or perineoplasty was performed in 33 cases. At 12-month followup 41 patients (82%) are completely continent, 7 patients (14%) reported more than 50% decrease in pad usage and 2 cases are considered surgical failures. Mean operative time was 28 minutes.

Conclusions: Data suggest that our new minimally invasive procedure provides a safe, effective and easy to learn alternative for treatment of women with anatomical stress incontinence.