Our changing strategies on bladder neck suspension operations

Area of Science:

• Urology
• Gynecology
• Surgical Innovation

Background:

• Female stress urinary incontinence (SUI) presents challenges in correcting urethral hypermobility and intrinsic sphincter dysfunction.
• Current surgical strategies require continuous evaluation for optimal patient outcomes.

Purpose of the Study:

• To retrospectively review operative results for SUI in women.
• To identify a surgical solution that effectively addresses both urethral hypermobility and intrinsic sphincter dysfunction with high success rates.

Main Methods:

• Comparative retrospective review of three surgical techniques: No Incision Bladder Neck Suspension (NIBNS), Modified Four Corner Bladder Neck Suspension (MFCBNS), and in situ vaginal wall sling with bone fixation.
• Patient cohorts included 24 (NIBNS), 26 (MFCBNS), and 25 (in situ sling) patients.
• Pre- and postoperative evaluations were conducted to determine success rates.

Main Results:

• NIBNS cure rates: 90.47% (6 months), 72.2% (2 years), 50% (5 years).
• MFCBNS cure rates: 96% (6 months), 75% (2 years).
• In situ vaginal wall sling cure rates: 100% (primary, 1 year), 80% (secondary, 1 year), 88.8% (primary, 2 years).

Conclusions:

• The in situ vaginal wall sling with bone fixation offers a superior solution for SUI.
• This technique effectively corrects urethral hypermobility and intrinsic sphincter dysfunction.
• Fixation and elevation of the urethrovesical junction, with urethral compression, contribute to the high success rates.