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Related Experiment Videos

A simple objective method of adjusting sling tension.

A Nguyen1, S Mahoney, L Minor

  • 1Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.

The Journal of Urology
|October 19, 1999
PubMed
Summary

This study introduces a simple method to adjust pubovaginal sling tension during surgery, preventing urinary obstruction. The technique effectively manages stress urinary incontinence with good patient outcomes.

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Area of Science:

  • Urology
  • Female Pelvic Medicine and Reconstructive Surgery

Background:

  • Pubovaginal slings are common for stress urinary incontinence (SUI).
  • Excessive sling tension can cause postoperative urinary obstruction.

Purpose of the Study:

  • To describe an objective, single-surgeon technique for intraoperative pubovaginal sling tension adjustment.
  • To prevent over-tensioning and subsequent obstructed voiding.

Main Methods:

  • A cotton swab is used to guide tension adjustment at the urethrovesical junction.
  • Sling sutures are secured to rectus fascia, aiming for a 0-10 degree cotton swab angle.
  • The technique was applied to 29 patients undergoing pubovaginal sling surgery.

Main Results:

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  • No permanent urinary retention occurred in the study group.
  • 15 patients voided normally post-catheter removal; 13 required short-term intermittent catheterization.
  • Preoperative detrusor instability resolved in all patients.

    • Conclusions:

    • The described technique effectively prevents over-tensioning of pubovaginal slings.
    • This method is reproducible and can be performed by a single surgeon.
    • It offers a reliable approach to managing SUI while minimizing obstruction risk.