The development of the intravaginal slingplasty procedure: IVS II - (with bilateral 'tucks')

A new local anaesthetic procedure, the intravaginal slingplasty operation performed with bilateral 'tucks' was performed on 39 patients with stress incontinence, and 18 patients with urge incontinence. The operation is performed through a 1-2 cm suprapubic incision and works by creating an artificial pubourethral ligament and by tightening the suburethral vagina. The primary operation cured 64% of 39 patients with stress incontinence, and 90% of 18 patients with urge incontinence. A minor surgical adjustment to the vaginal wall tension in the failed S1 group at a later date improved the 15 month success rate to 90%. This procedure is promising in that it is minimally invasive, does not require postoperative catheterization, and allows return to work within 7-10 days. The results emphasize the importance of the pubourethral ligament and adequate suburethral vaginal tension for adequate bladder neck closure, and the effect of bladder neck scarring in the causation of urinary incontinence. Further development is required.