OBJECTIVE:

Various surgical techniques have been described for the treatment of stress urinary incontinence (SUI). Midurethral intravaginal sling (IVS) operations to treat the SUI were effectively used from 1996. In this paper, we aimed to assess the effectiveness of midurethral IVS procedure that based on subjective evaluation in the treatment of SUI, after 2 years follow-up and the topic was discussed along with the review of literature.

MATERIAL-METHODS:

This prospective clinical trial was carried out in gynecology department of Kirikkale Yasam Private Hospital. 40 patients diagnosed with SUI were undergone to the midurethral IVS operation between the date of October 2005 and August 2006. All patients were evaluated in preoperative period with history, clinical examination, stress test and SEAPI subjective questionnaire. All IVS procedures were performed by using of special device and synthetic polypropylene mesh under epidural anesthesia. Effectiveness of IVS operations were evaluated in postoperative 1.,6.,12. ve 24. months by stress test and questioning of patient’s satisfaction based on SEAPI questionnaire.

RESULTS:

33 patients (82,5%) were completed 2 years follow-up survey. 29/33 patients (87,9 %) were cured from stress incontinence according to the stress test and and SEAPI scores. De novo urge incontinence was developed in 2/33 patients (%6,6). Mean operating time was 40,3 minutes (25-120). Two bladder injury complications were recorded. Bladder injuries were diagnosed during the operations by cystoscopy and primary repair was performed by laparotomy. We didn’t encounter any voiding difficulties.

CONCLUSION:

Our data demonstrates that IVS for the treatment of SUI is a feasible and reliable technique with high long term effectiveness, easy application, shorter operation time and lower complication rates.

Keywords: Stress incontinence, intravaginal midurethral sling operation