[Suburethral sling urethropexy: a vaginal approach]

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Surgery

Background:

• Traditional bladder neck suspensions and retropubic approaches have limitations, especially in obese patients or those with intrinsic sphincter deficiency.
• Complex sling procedures can pose challenges for surgeons.

Purpose of the Study:

• To evaluate the efficacy and safety of a simple vaginal sling urethropexy procedure.
• To assess outcomes in patients with stress urinary incontinence, including those with prior surgical history or obesity.

Main Methods:

• A transvaginal approach was used to suspend a rectus abdominis muscle flap under the bladder neck using polypropylene sutures.
• 25 patients with stress or mixed urinary incontinence underwent the procedure, with data collected on demographics, pre-operative symptoms, operative details, and post-operative outcomes.

Main Results:

• The procedure demonstrated a cure rate of 76% and improvement in remaining patients, with 73% overall satisfaction.
• Common post-operative issues included transient urinary retention (10 patients) and suprapubic wound infections (6 patients).
• Average follow-up was 22 months, with minimal blood loss and a relatively short hospital stay.

Conclusions:

• The simple vaginal sling urethropexy is an effective and straightforward surgical option for stress urinary incontinence.
• This technique is particularly suitable for previously operated patients and those who are obese.
• It offers a simpler alternative to conventional retropubic or combined sling procedures.