title: A modified vaginal wall patch sling technique as a first-line surgical approach for genuine stress incontinence with urethral hypermobility: long-term follow up.
abstract: We describe our long-term outcome for patients with genuine stress incontinence (GSI) and urethral hypermobility using a modified vaginal wall patch sling technique. Fifty-three patients were studied. Preoperatively, all patients had a positive standing stress test and urethral hypermobility on Q-tip testing. On urodynamics, all patients had absence of detrusor contractions on subtracted cystometry. The mean age of the patients was 45+10.2 years. Forty-four patients demonstrated complete symptomatic and urodynamic improvement. Five patients had a noticeable failure observed within the first 12 months of follow up and four patients developed later recurrence despite initial success. The overall success rate after 5 years of follow up was 83% (n=44/53). The modified vaginal wall patch sling technique appears to have a good long-term success rate with low operative morbidity and minimal postoperative voiding dysfunction. The patch sling can be used as a first-line surgical approach for GSI with urethral hypermobility and be combined with other vaginal surgery.
authors.affiliation: Female Pelvic Medicine & Reconstructive Surgery, Albert Einstein College of Medicine, Bronx-Lebanon Hospital Center, Department of Obstetrics & Gynecology, 1650 Grand Concourse, Bronx, NY 10457, USA. mikhailgyn@aol.com
authors.forename: Magdy S
authors.initials: MS
authors.lastname: Mikhail
authors.forename: Hector
authors.initials: H
authors.lastname: Rosa
authors.forename: Paul
authors.initials: P
authors.lastname: Packer
authors.forename: Prabhudas
authors.initials: P
authors.lastname: Palan
authors.forename: George
authors.initials: G
authors.lastname: Lazarou
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D019736:Prostheses and Implants; D012189:Retrospective Studies; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000628:therapy*