[Treatment of effort stress incontinence using a mechanical procedure. Personal technique]

On March 14th 1992, a female patient (P.C.O.) with CR 167584, underwent surgery for urinary exertional incontinence. We followed an original technique as a first (worldwide?) experience, using a pneumatic stapler designed for the management of this condition. The approach is vaginal, the active end of the stapler is introduced into the cavity and propped up against the anterior side of this organ close to the urethra: from this point and once the position is secured, the devise is pressed against the internal side of the pubis and a staple is projected fastening the vagina's ceiling to the interior side of the pubis. A total of eight procedures were performed, but only the first patient maintains a steady continence as the staple stays in the same position it was planted. In all remaining cases, the staples fell off over the subsequent weeks and the patients returned to the early incontinence state. The reasons for the inefficacy of this first prototype are analyzed, providing an explanation for the rationale behind this report four years after the experience.