Trocar-assisted sling suspension for stress urinary incontinence.
OBJECTIVE
To introduce a new approach in trocar-assisted sling suspension (TASS) for genuine stress incontinence.


METHODS
Prospective, observational study (Canadian Task Force classification II-2).


METHODS
University-affiliated hospital.


METHODS
Twenty-four women with genuine stress incontinence.


METHODS
TASS.


RESULTS
After standard preparation and under general endotracheal anesthesia, the periurethral space and thicker part of pubocervical fascia was opened from the vagina. An 0.5-cm incision was made on both sides of the lower abdomen 4 cm lateral to the linea alba and 2 to 3 cm above the pubic bone. A trocar was used to penetrate the incision site to the space of Retzius. A folded polypropylene mesh, 2 cm wide and 30 cm long, inside the vagina was pulled outside the trocar with laparoscopic forceps. All procedures were completed as planned. Average blood loss was less than 50 ml and operating time was 20 to 90 minutes. One woman had voiding difficulty and two had detrussor instability, but no bladder injury occurred (overall complication rate 12.5%). At 2-year follow-up, 23 of 24 women were satisfied with the results.


CONCLUSIONS
TASS is a feasible surgical procedure for managing stress incontinence. Since urinary incontinence surgery is usually combined with other gynecologic procedures, the laparoscopic trocar that is used during TASS can be used for concurrent surgery.
Lee
Chyi-Long
CL
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan, Taiwan.
Yen
Chih-Feng
CF
Wang
Chin-Jung
CJ
Yuen
Leung-To
LT
Lee
Pei-Shan
PS
Soong
Yung-Kuei
YK
D000328:Adult; D000368:Aged; D000475:Alkenes; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013525:Surgical Instruments; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*
D000475:Alkenes; C013658:propylene