Percutaneous needle bladder neck suspension for the treatment of stress urinary incontinence in women: Long-term results

Purpose: We evaluated the long-term results of percutaneous needle suspensi on using bane anchor devices for treating stress urinary incontinence in wo men. Materials and Methods: We retrospectively evaluated the long-term results o f percutaneous bladder neck needle suspension performed at our institution. None of the women had undergone any anti-incontinence surgery before percu taneous needle suspension. A telephone survey was done for all available pa tients. Subjective cure was defined as no evidence of incontinence, signifi cant improvement as 0 to 1 protective pad soaked daily and patient, satisfa ction with incontinence level, and failure as more than 1 pad used daily, l ack of patient satisfaction or a secondary procedure required to treat stre ss urinary incontinence, In cases considered failures a detailed video urod ynamic study was performed when possible before any secondary procedure. Results: In 1996 and 1997, 49 patients underwent percutaneous needle bladde r neck suspension with bone anchors, of whom 42 (86%) were available for te lephone interview. Mean patient age was 57 years (range 31 to 77) and mean followup was 29 months (range 16 to 52). As defined, subjective outcome in the 42 women was cure in 2 (5%), significant improvement in 5 (12%) and fai lure in 35 (83%). Of the 35 patients with treatment failure who did not und ergo a secondary procedure 25 were asked to present for video urodynamics a nd 18 were evaluated, Urodynamics revealed demonstrable urinary incontinenc e, urethral hypermobility in 16 (88%), intrinsic sphincter deficiency in 1 (6%) and detrusor instability in 1 (6%). In 2 cases x-ray revealed that a b one anchor had dislodged and migrated into the pelvis, Serious osteomyeliti s at the bone anchor site in 1 case required surgical debridement and 6 wee ks of intravenous antibiotics. Conclusions: Percutaneous needle suspension is associated with poor long-te rm results in women with stress urinary incontinence. Other procedures shou ld be considered.