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Endoscopic anchoring of the vesical neck new treatment for urinary stress incontinence



Endoscopic anchoring of the vesical neck new treatment for urinary stress incontinence



Archivos Espanoles de Urologia 41(2): 127-130



The authors describe a new technique in the treatment of stress incontinence. The procedure starts with a 2-3 cm. transverse incision just above the symphysis pubis, followed by a 5-6 mm. incision on the rectus fascia to permit insertion of a sound which is advanced inferiorly, along the posterior aspect of the symphysis, to the pelvic floor. Thereafter the sound is removed and through the same track, they introduce a 50 ml. balloon catheter mounted on a mandarin that permits dissection of the retropubic space to allow for post-operative formation of adherence to "weld" the vesical neck onto the symphysis. The new step consists of filling the bladder using a cystoscope and inserting a curved needle with resorbible suture through the rectus fascia, 1 cm. from the midline. It is introduced in the bladder at the level of the bladder neck, and taken out through the urethra. It is unthreaded and pulled out from above. The needle is inserted again at the same level as before but on the other side of the midline. It is pulled out through the urethra, threaded with the suture material coming out of the urethra, pulled and the suture material is removed through the suprapubic incision. Traction is then applied to both ends which are knotted on the rectus fascia, and the bladder neck is elevated and advanced.

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Accession: 005359083

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