In Situ Anterior Vaginal Wall Sling in Patients with Stress Urinary Incontinence

Shin, Myung Sik; Lee, Ji Youl; Lee, Dong Hwan; Cho, Su Yeon; Cho, Yong Hyun; Yoon, Moon Soo

Abstract

PURPOSE: The clinical outcome of the in situ anterior vaginal wall sling with bone anchor suture fixation was evaluated to determine the efficacy and safety in the treatment of women with anatomical incontinence(AI) and intrinsic sphincteric deficiency(ISD).
MATERIALS AND METHODS
62 women(45 with AI and 17 with ISD) underwent this modified sling procedure with the sling anchored to the pubic bone. Preoperative evaluation included detailed history, physical examination, urinalysis, urodynamic test, Q-tip test and incontinence staging with Stamey grade. All patients were followed up on a 3-month basis.
RESULTS
With a mean follow-up of 7.2 months(range 3 to 12), 61 women(98%) reported satisfaction (55 dry, 6 improved). Mean operative time was 72.5 minutes and mean hospital stay was 4.2 days. Mean postoperative catheter drainage was 5.4 days and 3 patients(5%) required prolonged catheter drainage, which required more than 2 weeks but no longer than 1 month. De novo urgency developed in 3(5%) patients.
CONCLUSIONS
In situ anterior vaginal wall sling represents an effective, simple and safe option for the treatment of both anatomic incontinence and intrinsic sphincteric deficiency.