Dynamic rectus abdominis tendon colposuspension for female stress urinary incontinence: a new procedure and its follow-up.
OBJECTIVE
To describe the technique, results and follow-up of dynamic rectus abdominis tendon colposuspension (DRTC) in the management of female stress urinary incontinence (SUI).


METHODS
Eighteen patients with SUI were studied prospectively from 1998 to 1999 who underwent DRTC. Type I and type II SUI patients with or without mild to moderate cystocoele were included in the study. A complete preoperative work-up was done as described in detail in this article. Follow-up assessment was done at 6 weeks, 3 and 6 months and then annually involving a SEAPI quality-of-life score, a satisfaction questionnaire, urge symptoms and assessment of dryness.


RESULTS
Mean follow-up of these 18 patients was 20 +/- 6 months. Cure of symptoms and dryness was achieved in 16/18 (89%) of the patients. Four of 9 patients had residual urge symptoms and 2 developed de novo urge, which settled by 3 months; no patient required long-term anticholinergics. Three patients required clean self-intermittent catheterization (CSIC) immediately postoperatively but only 1 patient continued to perform CSIC after 3 months. Mean operating time was 41 +/- 10 min and mean hospital stay was 3.5 +/- 1 days. There were two failures, one in a patient with a neurogenic bladder and one in a patient with multiple previous pelvic operations. One so-called failure uses <2 pads/day postoperatively with an improvement in both symptom and dryness score. Postoperative complications include blood transfusion in 1, urinary tract infection in 1 and wound infection in 1 patient. All the patients with initial good results showed persistent results over follow-up.


CONCLUSIONS
DRTC is a simple procedure with minimal morbidity showing good results, which are consistent on follow-up.
Goel
Mahesh C
MC
Ysbyty Gwynedd, Bangor, Wales, UK. mahesh_goel@yahoo.co.uk
Roberts
J G
JG
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D017568:Rectus Abdominis / Q000601:surgery*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*