Sling operation for recurrent stress incontinence using the tendon of the palmaris longus

A sling procedure is described for recurrent stress incontinence in women who had been previously treated, unsuccessfully, by one or more surgical interventions. The procedure consists of combining a vaginal Kelly urethral plication with a sling prosthesis, using the tendon of the palmaris longus. The former will correct the bladder neck funneling while the latter will restore its position to a high retropubic point, in a hammock suspended from Cooper's ligament. The palmaris longus is one of the superficial groups of flexors. Its advantages are in the tendon's availability, its location for accessibility, its relative ease of removal, and the fact that it is functionally nonessential. Six patients have been treated with this technique with excellent results after one to three years of follow-up.