TRANSVESTIBULAR RETROPUBIC BLADDER NECK SUSPENSION - A PILOT-STUDY

A pilot study was conducted assessing the operative feasibility, compl ications and results of a retropubic bladder neck suspension performed through a transvestibular approach. This study extended from July 1, 1990, to June 30, 1991, and included patients who planned to undergo p rimary surgical correction of stress urinary incontinence. Through a t ransvestibular incision, a bladder neck suspension was performed by su turing the adjacent area of the vagina to the back of the pubic symphy sis or the puborectalis muscle near the pubic bone. Ten women were ent ered into the study. There was one notable complication, a hematoma in the space of Retzius. One patient described worsening of her incontin ence and underwent a Marshall-Marchetti-Krantz procedure three months postoperatively. The mean follow-up for the remaining nine patients wa s 27 months (range, 13-31). At this writing, 6 patients were completel y continent, 1 was improved, and 2 had some degree of bladder instabil ity with associated incontinence. Overall, the transvestibular procedu re was thought to be technically difficult. Based on very limited data , the results of the study have discouraged our continued use of this procedure. The transvestibular approach may be applicable occasionally on selected patients.