PUBIC BONE SUBURETHRAL STABILIZATION SLING FOR RECURRENT URINARY-INCONTINENCE

A suburethral sling anchored to the posterior-inferior aspect of the p ubic bane with bone strews placed transvaginally is described for recu rrent urinary incontinence. The technique involves placing a suburethr al patch of a synthetic fiber at the junction of the upper one-third a nd lower two-thirds of the urethra and securing it by titanium bone sc rews to the posterior-inferior pubis for site-specific urethral suppor t and stabilization of normally positioned continence anatomy. The pro cedure was performed from August 1990 through December 1991 in 27 pati ents with recurrent stress urinary incontinence after previous urinary incontinence surgery, of whom 25 patients were followed yearly until August 1994. None of these 25 patients have had a recurrence as of Aug ust 1996. The initial success of the pubic bone suburethral stabilizat ion sling merits further study for the cure of urinary incontinence in patients with a hypermobile urethra or low-pressure urethral conditio ns. (C) 1997 by The American College of Obstetricians and Gynecologist s.