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Transvestibular retropubic bladder neck suspension. A pilot study
1Department of Obstetrics and Gynecology, Tampa General Hospital, University of South Florida College of Medicine 33606, USA.
The Journal of Reproductive Medicine
|March 1, 1995
Summary
This pilot study evaluated a transvestibular approach for bladder neck suspension surgery to treat stress urinary incontinence. The procedure was technically difficult, with limited success, discouraging its continued use.
Area of Science:
- Urology
- Gynecologic Surgery
Background:
- Stress urinary incontinence (SUI) is a common condition affecting women.
- Surgical correction is often necessary for primary SUI.
- Traditional retropubic bladder neck suspension has established efficacy.
Purpose of the Study:
- To assess the operative feasibility of a transvestibular approach for retropubic bladder neck suspension.
- To evaluate the complications and outcomes of this novel surgical technique.
- To determine the potential applicability of the transvestibular approach for SUI treatment.
Main Methods:
- A pilot study involving ten women undergoing primary surgical correction for SUI.
- A transvestibular incision was utilized for bladder neck suspension.
- Suturing the vagina to the pubic symphysis or puborectalis muscle was performed.
Main Results:
- One significant complication (hematoma) and one case of worsened incontinence were noted.
- Mean follow-up for nine patients was 27 months.
- Six patients achieved complete continence, one improved, and two experienced bladder instability.
Conclusions:
- The transvestibular approach for bladder neck suspension was technically challenging.
- Limited data suggests discouraging continued use due to technical difficulty and variable outcomes.
- The transvestibular approach may have occasional utility in carefully selected patients.