MODIFIED IN SITU VAGINAL WALL SLING IN THE TREATMENT OF FEMALE STRESS URINARY INCONTINENCE

The modified in situ vaginal wall sling technique was retrospectively evaluated in the treatment of female stress urinary incontinence (SUI).

A total of 37 female patients who had SUI (mean age 52 years, range 41-69) were treated using a modified in situ vaginal wall sling technique. The modification in the technique we employed was sewing the sling tissue with continuous helical sutures. The etiology of incontinence was urethral mobility in 29 cases, while intrinsic sphincter deficiency in 8. Cystocele and rectocele repair was done at the same session in 9 and 2 patients, respectively.

Mean operation time was 45 minutes (range 30-90). Complications were bladder perforation in 2, bleeding in 1, infection at suprapubic incision site in 2, and chronic pain in 1 case. Although a transient urinary retention was noted in 12 patients, persistent urinary retention was reported in none of the cases. De novo bladder instability was encountered in 1 patient. Mean follow up was 18 months (range 3-44). Cure and improvement was achieved in 31 and 4 cases, respectively. The operation was unsuccessful in 2 (5%) patients.

We believe that the modified in situ vaginal wall sling technique is a safe and effective surgical treatment for all types of stress urinary incontinence.