Surgical treatment of urinary stress incontinence using a method for postoperative adjustment of sling tension...

We present a technique that allows postoperative adjustment of the sling tension in female patients with urinary stress incontinence (USI). Twenty-one female patients with urodynamically proven USI were prospectively evaluated. Subjective and objective evaluation was made preoperatively, 6 months postoperatively and yearly thereafter. Mean age was 63.5; mean parity was 2.3. All patients were postmenopausal and 13 (62%) had had previous surgery for USI. The operating time was 32 minutes (range 25-45). At a mean follow-up of 12 months (6-25), 19 patients (90.5%) were very satisfied. Two patients (9.5%) were considered failures but subjectively were satisfied and refused readjustment. One patient (4.7%) developed 'de novo' detrusor instability. In conclusion, this is a sling procedure for patients with previous failed surgery and those with intrinsic sphincter deficiency (ISD) with the peculiarity that the sling tension can be regulated postoperatively. The readjustment can be made in the office, months or even years after the procedure.