THE ROSTI SLING: A NEW, MINIMALLY INVASIVE, TENSION-FREE TECHNIQUE FOR THE SURGICAL TREATMENT OF FEMALE URINARY INCONTINENCE—THE FIRST 217 PATIENTS
2004; Lippincott Williams & Wilkins; Volume: 171; Issue: 4 Linguagem: Inglês
10.1097/01.ju.0000118050.97487.cd
ISSN1527-3792
AutoresE. Laurikainen, J. ROSTI, Y Pitkänen, Pentti Kiilholma,
Tópico(s)Urinary Bladder and Prostate Research
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Apr 2004THE ROSTI SLING: A NEW, MINIMALLY INVASIVE, TENSION-FREE TECHNIQUE FOR THE SURGICAL TREATMENT OF FEMALE URINARY INCONTINENCE—THE FIRST 217 PATIENTS E. LAURIKAINEN, J. ROSTI, Y. PITKÄNEN, and P. KIILHOLMA E. LAURIKAINENE. LAURIKAINEN More articles by this author , J. ROSTIJ. ROSTI More articles by this author , Y. PITKÄNENY. PITKÄNEN More articles by this author , and P. KIILHOLMAP. KIILHOLMA More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000118050.97487.cdAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the outcome of a new, innovative, inexpensive tension-free technique, the Rosti sling (RS), for female urinary incontinence. Materials and Methods: RS was performed in 217 patients under local (45%), spinal (52%) or general (3%) anesthesia. A 1.5 × 33 cm strip of polypropylene mesh was inserted under the mid urethra from above through small suprapubic stabs down and out through a 1.5 cm midline vaginal incision using the Stamey needle. Of the women 76% had stress urinary incontinence and 24% had mixed incontinence. Patient age was 24 to 90 years (mean 56) and parity was 0 to 6 (mean 2). The diagnosis of incontinence was based on history and physical examinations with a cough stress test. Mean followup was 23 months. Results: Mean operative time was 25 minutes (range 15 to 45) and mean hospital stay was 3 days (range 1 to 12). Perioperative complications were bladder and urethral perforations in 2 and 1 cases, respectively (1.4%), and hematoma in 3 (1.4%). There was postoperative retention with a variable duration in 49 patients (23%), of whom 41 underwent Hegar dilation. Altogether 186 of 215 patients (86.5%) were cured of incontinence. Two patients were lost to followup and 14 (16.3%) had de novo urge incontinence. The cure rates were 87% for stress urinary incontinence and 91% for mixed incontinence. The cure rate in patients treated under local and spinal anesthesia were 82% and 91%, respectively (p = 0.1084). The rates for RS with recurrent vs primary incontinence were 84% vs 87% (p = 0.5800) and for RS with vs without Hegar dilation 80% vs 88% (p = 0.2094). Conclusions: The technique described is simple, safe and inexpensive. The cure rates are comparable to those of tension-free vaginal tape. However, because of the relatively high rate of postoperative voiding difficulties compared to tension-free vaginal tape, this technique can be criticized. To avoid these problems special attention should be focused on applying the mesh without tension and with precision. References 1 : Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol1995; 29: 75. 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Google Scholar 19 : Results and complications of tension-free vaginal tape (TVT) for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct2001; 12: 370. Google Scholar 20 : Tension-free vaginal tape (TVT) in women with recurrent stress urinary incontinence—a long-term followup. Int Urogynecol J Pelvic Floor Dysfunct2001; 12: S9. Google Scholar From the Departments of Obstetrics and Gynecology, Turku University Hospital, Turku and Salo Local Hospital, Salo, Finland© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 171Issue 4April 2004Page: 1576-1580 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsprolapseurethraprostheses and implantssurgical meshurinary incontinenceMetricsAuthor Information E. LAURIKAINEN More articles by this author J. ROSTI More articles by this author Y. PITKÄNEN More articles by this author P. 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