[Percutaneous urethral suspension with bone anchorage (Vesica) in the treatment of stress urinary incontinence. Results after a year of follow-up].

OBJECTIVES

Evaluation of efficacy of percutaneous bladder neck suspension with bone anchors in women with stress incontinence with no previous treatment.

PATIENTS AND

METHODS

Fourteen women (mean age 48, range 37-74) were operated. All had a stable bladder and objective leakage, either by pad test of by physical examination. Ten were evaluated by a incontinence questionnaire. Mean incontinence time before the procedure was 3.9 years. All needed pads (mean 3.3 pads/day). The surgical technique is described.

RESULTS

Mean surgical time was 80 minutes. In three patients there was bladder perforation during the procedure, that was solved by delaying the catheter withdraw. Mean postoperative stay was 4.2 days, with good tolerance, and one patient was discharged with a cystostomy. After a minimum follow-up of one year (mean 17.5 months), eleven patients have improved their continence (6 dry, 5 socially acceptable incontinence < pads/day) and 3 have recurrence. Postoperative pad test was < or = 10 g in patients without improvement and over 20 g in patients who failed. Mean postoperative total score in the questionnaire decreased from 10.1 to 2.5 in patients who improved and didn't change in patients who failed.

CONCLUSION

Percutaneous bladder neck suspension is a useful alternative to open interventions, due to its low morbidity and lower postoperative stay.