29th Congress of the Société Internationale d’Urologie

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Research Title: 
POS-01.06: Novel Technique for the Treatment of Stress Urinary Incontinence: Early Outcomes
Mahmoud Mustafa
Sun, 2007-09-02
POS-01-06_Novel_Technique_for_the_Treatment_of_Stress_Urinary_Incontinence_Early_Outcomes.pdf59.6 KB
Research Abstract: 

Purpose: To evaluate the efficacy of using placard-shaped insitu anterior vaginal wall sling, reinforced with semi-size polypropylene mesh, in the treatment of stress urinary incontinence.
Material & Methods: Twelve patients with mean age of 51.08 years (range 27-73) were operated upon due to stress urinary incontinence (SUI) from Augustus 2006 to February 2007. In all patients, gynecologic examination revealed urethral hypermobility with or without cystocele. Only one patient was operated before due to SUI while the remaining patients were primary cases. The placard-shaped insitu anterior vaginal wall sling, reinforced with semi-size monofilament polypropylene tape, was used as anti-incontinence surgery. The mean follow-up period was 3.83 months (range 2-8). Intra-operative cystoscopy was performed in each patient to rule out urethral or bladder penetration All patients were hospitalized for one to two days. Foley catheter was removed after one week in the postoperative period. Measurement of the post voiding residual urine was done by real abdominal ultrasound after the removal of Foley catheter.
Results: All patients had benefit from the surgery; Ten patients completely cured and two patients showed partial improvement. The ages of these two patients were 73 and 69 years respectively and the later case was diabetic. One patient had urinary retention which was resolved after decrease the tension of suspension sutures in theater under anesthesia. One patient had wound sepsis in form of suprapubic tenderness and redness which was treated by oral antibiotics and anti-inflammatory drugs. Neither bowel nor urethral injuries were recorded and cystoscopy revealed no bladder penetration. No post voiding residual urine was detected after catheter removal.
Conclusion: The early results of this technique is encouraging. It is easy to learn and economic with good success rate. Urethral erosion is less likely to occur due to the presence vaginal mucosa between mesh and urethra. Also long term success is expected, as no relaxation of the suspension suture will occur. Longer term follow-up and larger number of patients is needed before a final conclusion could be drawn.