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POS-01-06_Novel_Technique_for_the_Treatment_of_Stress_Urinary_Incontinence_Early_Outcomes.pdf | 59.6 KB |
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.