Endoscopic Suspension of the Vesical Neck for Urinary Incontinence in Females: Report on 203 Consecutive Patients

摘要: The key to restoring urinary continence in the female is raise internal vesical neck of bladder a position behind symphysis pubis. operation which accomplishes this with least morbidity, most accuracy and greatest permanency endoscopic suspension; it particularly applicable patients obesity, multiple operative failures, radiation incontinence, severe pelvic fractures. Between December 1973 May 1979, 203 underwent 211 operations minimum six months follow-up study at final review (November 1979). Twenty per cent were totally incontinent on referral, 60 lost urine minimal activity; only 20 had typical stress requiring coughing or sneezing lose urine. Among patients, there 188 previous for including 74 Marshall-Marchetti retropubic repairs. Forty-seven have been followed over four years, 156 years. While 138 hysterectomy, 65 not; presence uterus did not affect results. Urinary incontinence an indication hysterectomy. Ninety-one cured their by suspension neck. Technical advantages suspensions include use monofilament heavy nylon (No. 2), vaginally placed Dacron® buttress prevent tearing pubocervical fascia, less postoperative blood loss, functional measurements anatomic visualization restored during procedure, easy access surgically difficult pelvis, simultaneous repair significant rectoceles substantial cystoceles through same field.