Novel technique for the treatment of stress urinary incontinence. Early experience

OBJECTIVE: To evaluate the efficacy of in situ anterior vaginal wall sling, reinforced with polypropylene mesh, in the treatment of stress urinary incontinence (SUI).

METHODS: Seventeen patients with mean age of 51.29 years (range: 27-73) underwent surgery for SUI from August 2006 to August 2007 at Osmaniye State Hospital, Osmaniye, Turkey. Two out of 17 patients gave history of previous anti-incontinence surgical intervention, while the remaining were primary cases. In situ anterior vaginal wall sling, reinforced with semi-size monofilament polypropylene tape (size of the mesh was similar to size of in situ sling), was used as an anti-incontinence procedure. The mean follow-up period was 9.29 months (range: 4-16).

RESULTS: In-situ anterior vaginal wall sling reinforced with polypropylene mesh was successful in 16 (94.1%) patients, 14 of them were cured, and 2 had clinical improvement. There was no report of preoperative urethral, bladder, or bowel injury. One patient developed postoperative urinary retention that resolved after decreasing the tension of the suspension sutures, and one patient had suprapubic wound sepsis treated by oral antibiotics and anti-inflammatory drugs. No postoperatively significant post-voiding residue was detected.

CONCLUSION: The early results of this technique are encouraging. It is easy to learn, economical, with a good success rate. Urethral erosion is less likely to occur due to the presence of intervening vaginal mucosa. In the future, a prospective study recruiting a larger number of patients undergoing this technique with long-term follow-up is recommended.