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Laparoscopic Two-Team Sling for Stress Urinary Incontinence
1Department of Obstetrics and Gynaecology, Women's College Hospital, University of Toronto, 76 Grenville St., Toronto, Ontario, Canada M5S 1B2.
Summary
The laparoscopic two-team sling procedure offers a 95% success rate for recurrent stress urinary incontinence (SUI) in women. This minimally invasive approach provides a safe surgical alternative with a short hospital stay.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Female Pelvic Medicine
Background:
- Recurrent stress urinary incontinence (SUI) often requires surgical intervention.
- The two-team sling procedure, utilizing Marlex mesh, has a 20-year history with an abdominovaginal approach.
- Women with low urethral pressures are particular candidates for this procedure.
Purpose of the Study:
- To evaluate the efficacy and safety of the laparoscopic two-team sling procedure for recurrent SUI.
- To assess outcomes using both extraperitoneal and intraperitoneal laparoscopic approaches.
Main Methods:
- A prospective study of 100 women undergoing laparoscopic two-team sling procedures between July 1993 and February 1996.
- Procedures employed both extraperitoneal and intraperitoneal laparoscopic techniques.
- Data collected on success rates, complications, operating time, and hospital stay.
Main Results:
- An overall success rate of 95% was achieved with a mean follow-up of 1.5 years.
- Minor complications included small bowel perforation (1%), cystotomy (3%), voiding dysfunction (3%), and mesh erosion (3%).
- Mean operating time was 70 minutes, with an average hospital stay of 1.5 days.
Conclusions:
- The laparoscopic two-team sling procedure is a viable and effective surgical option for women with recurrent SUI.
- This minimally invasive technique demonstrates favorable outcomes and a manageable complication profile.
- The procedure offers a suitable alternative to traditional open surgical methods.