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The vaginal wall sling: a compressive suspension procedure for recurrent incontinence in elderly patients
D R Couillard1, K A Deckard-Janatpour, A R Stone
1Department of Urology, University of California, Davis School of Medicine, Sacramento.
Objective:
To determine the efficacy of the vaginal wall sling in the management of recurrent stress urinary incontinence (SUI) in an elderly female population.
Method:
Eighteen elderly female patients (average age 68.4 years) with recurrent stress urinary incontinence were studied with a thorough evaluation including video-urodynamics. Thirteen patients were diagnosed with type III SUI and 5 patients had type II SUI: A description of the technique, first described by Raz, is provided.
Results:
Follow-up ranged from six to forty-two months (average 18 months). All patients are completely dry and express satisfaction with their outcome. Seventeen of 18 patients (94%) are voiding spontaneously. One patient at twelve months' postoperation requires clean intermittent catheterization.
Conclusion:
Many elderly female patients with recurrent stress urinary incontinence have intrinsic urethral sphincteric incompetence as well as recurrent hypermobility that often classifies them as type II SUI: The vaginal wall sling addresses both problems and is a safe, simple, and effective procedure in the management of recurrent incontinence in elderly female patients.