[Subtrigonal sling with abdominal fascia for treatment of complex stress urinary incontinence].
BACKGROUND
The aim of this study was to describe the technique of subtrigonal sling with abdominal fascia and demonstrate its usefulness in resolving complex stress urinary incontinence (SUI).


METHODS
We performed a cohort, longitudinal, observational study in adult females who attended the Urodynamics Department of the Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexico City, with recurrent SUI or with risk factors for recurrence, whether or not associated with urge urinary incontinence (UUI).


RESULTS
Between 1995 and 2006, 40 patients were included. Mean follow-up was 41.95 months (9-106), and the average patient age was 55 years. In 35 patients (87.5%) SUI was resolved, in two patients (5%) it improved, and in three patients (7.5%) it persisted. Of the 40 study patients, 18 had UUI and in only 7/18 patients (39%) was it resolved postoperatively. UUI de novo was noted in 12/40 patients (30%). One patient presented crural hernia, two patients presented postincisional hernia and two patients required blood transfusion. No patient presented acute urinary retention or urinary voiding problems postoperatively.


CONCLUSIONS
Results obtained by this surgical technique are effective and long-lasting in patients with complex SUI. We did not observe bladder emptying dysfunction but there were formations of abdominal wall hernias. The minimally invasive approach consisting of the subtrigonal placement of synthetic tapes may maintain efficacy with minimal morbidity.
Serrano-Brambila
Eduardo Alonso
EA
Departamento de Urodinamia, Servicio de Urología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., Mexico. eserranob@hotmail.com
Maldonado-Alcaraz
Efraín
E
Espinoza-Guerrero
Xavier Abraham
XA
Moreno-Palacios
Jorge
J
Ixquiac-Pineda
Guillermo Antonio
GA
Cárdenas-Rodríguez
Edgar
E
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods