title: Endopelvic free anchor minisling technique for stress urinary incontinence treatment: 10 years of experience.
abstract: OBJECTIVE
  We present our 10-year experience in treating stress urinary incontinence (SUI) using a new minisling technique based on a tension-free vaginal tape band designed by our group. The major advantage of this tape is the use of minibelt polypropylene inserted through a single retropubic incision without the use of needles-the Endopelvic Free Anchor (EFA)-based on its location at the midurethra with a U shape. For insertion, each branch is placed using a simple Pean clamp from the vagina with perforation of the endopelvic fascia to achieve a retropubic insertion.
  
  
  METHODS
  From May 2001 to May 2011, we surgically treated 166 women with primary first- or second-degree SUI due to urethral hypermobility without genital prolapse. All were evaluated according to our study protocol, which included clinical and urodynamic evaluation before and 12 months after surgery.
  
  
  RESULTS
  With a median follow-up of 5 (1-11) years, 152 patients (91.6 %) were fully cured both from urodynamic and subjective points of view. Six patients (3.6 %) had significant improvement, and eight (4.8 %) were identified as technique failure. Complications included one bladder perforation (0.6 %), two cases of postoperative urinary retention (1.24 %), two of retropubic hematoma (1.24 %), and one of de novo urgency (0.6 %). No reinterventions were necessary, and there were no major bleeding complications, no chronic pain or de novo dyspareunia, and no voiding difficulty.
  
  
  CONCLUSIONS
  EFA is a viable, safe, and effective technique for treating UI due to urethral hypermobility.
authors: Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain.
authors: Juan
authors: J
authors: Gambini-Ricapa
authors: Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain.
authors: Javier
authors: J
authors: García-Oms
authors: Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain.
authors: Miguel
authors: M
authors: Barea
authors: Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain.
authors: Angeles
authors: A
authors: Estrada
authors: Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain.
authors: Alejandra
authors: A
authors: Iturri
authors: Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain.
authors: Juan
authors: J
authors: Gambini-Buchon
authors: Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain. gilabert_juaest@gva.es.|Departamento de Pediatria, Obstetricia y Ginecología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain. gilabert_juaest@gva.es.
authors: Juan
authors: J
authors: Gilabert-Estelles
mesh_terms: D000328:Adult; D000368:Aged; D003558:Cystoscopy / Q000295:instrumentation / Q000379:methods*; D005205:Fascia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery; D011126:Polypropylenes; D011184:Postoperative Period; D011446:Prospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000150:complications / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D014621:Vagina / Q000601:surgery
chemical_list: D011126:Polypropylenes
keywords: Endopelvic free anchor; Mesh; Minisling; Stress urinary incontinence