"Sandwich technique" for suburethral placement of Mersilene mesh sling during pubovaginal suspension surgery: preliminary results.

OBJECTIVES

To evaluate the effectiveness of a new "sandwich technique" for heterologous sling placement during pubovaginal suspension for treatment of recurrent stress urinary incontinence.

METHODS

A new sling placement procedure was used in 31 women (mean age 65.4 years) who had undergone multiple operations. With this technique, a heterologous sling was placed without dissection over a de-epithelialized vaginal wall and later covered with a vaginal wall flap. Finally, the sling and the bladder neck were suspended from the pubic bone with metallic anchorages and nonabsorbable sutures.

RESULTS

The objective success rates for SUI resolution was 87.1% but, subjectively, 90.3% of patients were satisfied or very satisfied with the procedure. The median follow-up time was 34 months. Morbidity was minimal, and the mean hospitalization time was less than 5 days.

CONCLUSIONS

This original, simple, noninvasive treatment is applicable to all type II and type III SUI with or without associated cystoceles, regardless of patient age or sexual activity, and has shown encouraging results. This procedure is highly recommended for the treatment of SUI, especially in patients who have undergone multiple previous operations.