| abstract |
The surgical treatment of stress urinary incontinence can be improved by modifications that increase safety, efficacy and reproducibility. Thirty women with stress urinary incontinence underwent consecutive endoscopic bladder neck suspension with modifications designed to achieve those goals. Those modifications included: 1) a technique of probe passage to avoid injuring the bladder and to provide a more accurate and reproducible capture of the pubocervical fascia lateral to the bladder neck and urethra, 2) anchor fixation of the suspending sutures to the pubic bone to decrease the risk of suture pull through from above and to decrease post-operative pain and 3) a simple and reproducible technique to set a limited tension of the suspending sutures. procedures were outpatient or with one day of hospitalization beyond the day that their catheter was removed. The immediate post-operative success rate was 100 %. There was one failure in a follow-up to 8 months. Urinary urgency dropped from 63 % pre-operatively to 17 % post-operatively. The patients' satisfaction with the procedure was high. A description of these modifications and results of procedures with these modifications are disclosed. Novel drill guides suture passers and suture tensioners for use in the surgical method are also disclosed. |