| Sub-title | |
| Authors | J Mamo R Pullicino J P C Mamo C Frendo Balzan |
| Abstract | Objectives: The use of an autogenic material for the suspension of a bladder neck using the traditional sling procedure is compared with the new technique using synthetic multifilament polypropelene mesh tape for tension free vaginal sling procedure. Method: In this study both the autogenic sling and the synthetic multifilament polypropelene mesh tape were inserted retropubically using the same blunt tipped tunneller device. Through the suprapubic approach, a fascial strip is dissected from the aponeurosis of the external oblique muscle using a plastic rounded tip tunnelller the fascial strip is threaded retropubically. Both fascial strips are then plicated beneath the mid-urethra. The tunnelller is introduced paraurethrally through a midline incision at the level of the mid-urethra. In the synthetic mesh slingplasty group the tape is passed through the submucosal tunnel and brought up through a small abdominal incision. In both groups, the midline incision is closed using absorbable sutures. No vaginal packing was performed in either group. Results: The inguinovaginal fascial sling for genuine stress incontinence involves a laparotomy and delayed discharge from hospital compared to intravaginal synthetic mesh slingplasty which can be done as a day surgery. There were no intraoperative or postoperative complications. Ultrasonography for residual post void measurements was performed prior to discharge and four weeks post operatively. There was no post operative urinary retention, no mesh erosions and no urinary urgency reported in both groups. The tension free vaginal sling provides mid-urethral support during increasing abdominal pressure and less risk of voiding disfunction and urinary retention. |
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| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | fascial sling, surgery, transvaginal slingplasty, stress incontincence |