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.
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How_To_Achieve_Long_Term_Success_In_The_Treatment_of_Female_Urinary_Stress_Incontinence_Novel_Modification_on_Vaginal_Sling(Korean_J_Urol_2011).pdf | 2.64 MB |