An-Najah Staff

Purpose : To evaluate the efficacy of a simple and economic procedure using a placard-shaped in situ anterior vaginal wall sling for the treatment of stress urinary incontinence, with or without cystocele repair.
Methods : From July 2003 to July 2004, 14 female patients (mean age 45.21 years, range 37–57) were operated upon because of stress urinary incontinence (SUI) with the placard-shaped in situ anterior vaginal wall sling technique. The average follow-up period was 11 months (range 4–14.5 months). Twelve patients were operated primarily with this technique and only two patients had undergone previous surgeries for the treatment of SUI (one patient had had two previous surgeries and the other had had one previous surgery). In all patients urethral hypermobility or/and bladder prolapse were observed . Filling cystometry showed sufficient bladder capacity with no detrusor overactivity.
Results : No urinary retention was observed in any patient in the postoperative period. While 11 patients have 100% cure of incontinence, three patients started leakage of urine after 1–2 months after the operation (one patient had been operated upon twice before (and who was diabetic and obese) and two patients were primarily repaired by our technique). In two patients, suprapubic tenderness and redness were observed, and were treated by oral antibiotic and anti-inflammatory drugs.
Conclusion : The placard technique is simple, cost-effective and has low incidence of urinary retention in the post-operative period. The success rate seems to be satisfactory and it can be applicable to patients who are primary cases of SUI with average body mass index. Yet longer term follow up and larger number of patients are needed before final conclusion can be drawn.

Introduction: Our aim was to evaluate the efficacy of utilizing in situ anterior vaginal wall sling in the treatment of stress urinary incontinence (SUI).
Materials and Methods: The study included 11 women with a median age of 50 years (range, 36 to 60 years) who were operated on during the period of November 2005 to August 2006. They were diagnosed with SUI and were operated on using placard-shaped in situ anterior vaginal wall sling technique. Nine patients underwent surgical treatment for the first time, while 2 patients had postoperative recurrent SUI. In all of the patients, urethral hypermobility with or without cystocele was observed. The mean follow-up period was 22.5 months (range, 17 to 28 months).
Results: Ten patients (90.9%) were considered cured and 1 (9.1%) started leakage of urine after 1 month during the postoperative period. One patient (9.1%) had urinary retention. Three patients (27.3%) had evidence of wound infection which was treated by appropriate oral medical therapy.
Conclusion: In situ anterior vaginal wall sling technique is accredited with a good success rate and low incidence of complications. It is easy to learn and cost-effective, making it a suitable technique for SUI. Longer follow-up and larger number of patients are needed before final conclusion could be drawn.