The further development of the intravaginal slingplasty procedure: IVS IV - (with 'double-breasted' unattached vaginal flap repair and 'free' vaginal tapes)

The Intravaginal Slingplasty with 'double-breasted' vaginal flap repair and free vaginal tapes as performed in 40 unselected patients with primarily mixed or pure stress incontinence solved the problems of 'visco-elastic creep' and of the 'tethered vagina syndrome', but had a primary cure rate of only 72%, due to the tearing out of either the internal or external flaps. Subsequent adjustment under local anaesthesia improved the cure rate to 92%. Further development of the vaginal part of this technique is required.