LAUSR

Objective To evaluate the results of novel modifications on tension-free vaginal tape (TVT) in the treatment of female stress urinary incontinence (SUI). Methods In all, 16 female patients with a mean (range) age of 49.29 (31–78) years, who underwent anti-incontinence surgery to correct their SUI between June 2010 and August 2014, were included. An in situ anterior vaginal wall sling was prepared, and monofilament polypropylene tape passed below the in situ sling and the standard TVT procedure was performed. Both ends of the mesh in the suprapubic region were labelled with polyglactin 910 (Vicryl®, Ethicon Inc., Somerville, NJ, USA) sutures and left outside the wound. The middle of the mesh in the vaginal region was labelled with a similar suture and left outside the vagina. The Foley catheter was removed on the third postoperative day. The mean (range) follow-up was 8 (5–17) months. Results All patients benefited from the surgery; 15 (94%) of them were completely cured and one patient clinically improved. Urinary retention occurred in one patient, where the tension of the tape was reduced using adjustment sutures. No vaginal mesh erosion was detected during the gynaecological examination postoperatively. No significant post-voiding residue was detected after catheter removal. Conclusion This technique provides a feasible option for adjusting the tension of the mesh in the early postoperative period in case of urinary retention. The presence of the intervening in situ sling reduces the risk of vaginal erosion. Long-term success is expected because dislocation of the mid-urethral sling is less likely.