New and simplified vaginal approach for correction of urinary stress incontinence in women.

Twenty-four patients with urodynamically confirmed urinary stress incontinence were operated upon with a new and simplified vaginal approach. This new technique is a simplification of a previously described transabdominal surgical method, in which a two-component fibrin sealant (Tisseel) was used. The sealant resulted in an excess of fibrin, which induced fibrosis, securing the urethrovesical junction in an elevated position to the retropubic periosteum. In the present study, the sealant was deposited retropubically with a specially designed needle through the anterior vaginal wall. A great advantage with this procedure is that only local anesthesia is used and the patient can leave the outpatient clinic 1 hour after the operation. The minimum duration of the follow-up period was 18 months. The success rate was as high as 63%, and no side effects were observed.