Preventing urethral obstruction using the 6-point fixation and weight-adjusted spacing nomogram during sling surgery.

The aim of the study was to assess the outcome of a 6-point fixation technique and weight-adjusted spacing nomogram for performing sling surgery. Fifty women with stress incontinence underwent implantation of a Gore-tex patch sling. Sling tension was gauged based on the patient's body weight. Postoperative analysis was performed using cough stress tests, Q-tip tests, pelvic examinations and patient satisfaction questionnaires. Urodynamics were performed for women with persistent incontinence. Mean follow-up was 24 months (range 7-28). Mean age was 58 years (range 29-87). Stress incontinence was cured in 47/50 patients (94.0%). De novo urge incontinence occurred in 1/23 (4.3%) patients. Mean time to suprapubic tube removal was 7 days (range 1-21). No patients experienced urinary retention or urethral obstruction. Mean satisfaction score was 9/10 (range 7-10) and all patients said they would undergo surgery again. The combination of a 6-point fixation technique and a weight-adjusted spacing nomogram allows for a successful sling outcome without obstruction.