THE DEVELOPMENT OF THE INTRAVAGINAL SLINGPLASTY PROCEDURE - IVS-II - (WITH BILATERAL TUCKS)

A new local anaesthetic procedure, the intravaginal slingplasty operat ion performed with bilateral ''tucks'' was performed on 39 patients wi th stress incontinence, and 18 patients with urge incontinence. The op eration is performed through a 1-2 cm suprapubic incision and works by creating an artificial pubourethral ligament and by tightening the su burethral 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 SI 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 req uire postoperative catheterization, and allows return to work within 7 -10 days. The results emphasize the importance of the pubourethral lig ament and adequate suburethral vaginal tension for adequate bladder ne ck closure, and the effect of bladder neck scarring in the causation o f urinary incontinence. Further development is required.