An inexpensive mid-urethral sling for treating female stress urinary incontinence: the use of renal pedicle clamp and prolene mesh strips

Objective: Transobturator vaginal tape (TOT) is a widely used procedure for the management of female stress urinary incontinence (SUI). We reviewed our TOT results with the use of a polypropylene mesh strip and a renal pedicle clamp.

Materials and methods: Between 2004 and 2007 TOT was performed in 132 patients. Forty-nine patients with associated prolapse surgery were excluded from analysis. A 1-cm-wide polypropylene mesh strip was placed midurethrally via a renal pedicle clamp introduced through the transobturator route in 46 patients (Group 1). IVS04TM Tunneler was used in 37 patients who served as the control group (Group 2). Groups were compared for perioperative and postoperative complications, and continence outcomes. Follow-up studies included history, cough test, post-voiding residual urine volume (PVR), and International Consultation on Incontinence Questionnaire (ICIQ-SF) scores obtained at 1, 6, 12, 18, and 24 months.

Results: With a mean follow-up of 22.8 and 24.7 months, cure (defined as elimination of the need to wear protection, and the absence of stress leakage during a cough test) was achieved in 84% and 85% of the patients in Groups 1 and 2, respectively. There was no significant difference between the groups in terms of perioperative complications, or in incidence of postoperative urinary retention, vaginal erosion, or de novo urgency. Urethral erosion, hematoma, or wound infection was not observed.

Conclusion: TOT with the use of surgical polypropylene mesh strip and renal pedicle clamp is an inexpensive and effective procedure for the treatment of female SUI.