Introduction: Stress urinary incontinence can be attributed to various factors, including the weakening of the supportive layer resembling a hammock. While tension-free vaginal tape has been employed as a minimally invasive solution, it has many delayed complications. The objective of this study was to assess a novel minimally invasive approach utilizing autologous tissue flap to address stress urinary incontinence stemming from urethral hypermobility.
Patients and Methods: A prospective cohort study encompassing fifty patients afflicted by stress urinary incontinence due to urethral hypermobility. The patients underwent surgical intervention involving the application of an in-situ anterior vaginal wall flap as a sling. The primary outcome measure was the objective cure rate at the five-year mark. Secondary outcomes encompassed operative complications, the emergence of voiding problems postoperatively, urge symptoms, and urinary tract infections.
Results: The study yielded an objective cure rate for stress urinary incontinence of 80%, which slightly declined to 74% after a five-year follow-up period. Notably, 8% of patients exhibited de novo detrusor over-activity. Urinary tract infections were observed in 4% of cases, suprapubic wound infections in 2%, recurrent stress urinary incontinence in 4%, and extended time required to initiate voiding in 4% of cases.
Conclusion: The employment of an in-situ anterior vaginal wall flap proved to be an efficacious and cost-effective modality for addressing stress urinary incontinence linked to urethral hypermobility.