Patch procedure: modified transvaginal fascia lata sling for recurrent or severe stress urinary incontinence

Ten patients with either recurrent or severe stress urinary incontinence were treated with a new procedure, using a patch of fascia lata to support the bladder base and the urethra. Nine of the ten patients are objectively continent of urine 1-2 years postoperatively. When pre- and postoperative urodynamics were compared, we noted significant increases in urethral closure pressure, functional urethral length, and abdominal pressure transmission to the proximal urethra. Intraoperative and postoperative morbidity was minimal. The procedure is easily performed and requires no more expertise than does a transvaginal needle bladder neck suspension.