International Urogynecology Journal

, Volume 2, Issue 3, pp 123–126 | Cite as

Preliminary report: Modification of the needle urethropexy in the management of stress incontinence

  • D. A. Richardson
Original Article


The management of stress urinary incontinence continues to be a perplexing problem for the gynecologist. The needle urethropexy procedures have undergone extensive revision with modifications of Pereyra, Stamey, Gittes, and Raz. In 16 patients with severe pelvic floor relaxation a modified needle urethropexy was performed along with vaginal surgery for correction of prolapse. Two small suprapubic incisions are made. No vaginal incision is required. The Pereyra needle is passed twice on each side of the urethra from the rectus fascia through the full thickness of the vaginal mucosa at the level of the urethrovesical junction. A 5-mm Mersilene strip is used in the suspension. At 2 months vaginal mucosa has epithelialized over the strips in all patients. There were 5 objective failures, but 4 of these patients were subjective cures. Two patients developed vesical instability. One patient postoperatively was unable to void, and 4 months later the sutures were cut. Only 1 patient developed suture rejection 11 months after surgery.


Needle urethropexy Stress incontinence 


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  1. 1.
    Karram MM, Bhatia NN. Transvaginal needle bladder neck suspension procedures for stress urinary incontinence: a comprehensive review.Obstet Gynecol 1989; 73:906–914PubMedGoogle Scholar
  2. 2.
    Loughlin KR, Gittes RF, Klein LA, Whitmore WF. The comparative medical costs of two major procedures available for the treatment of stress urinary incontinence.J Urol 1982; 127:436–438PubMedGoogle Scholar
  3. 3.
    Stamey TA. Endoscopic suspension of the vesical neck for urinary incontinence.Surg Gynecol Obstet 1973; 136:547–554PubMedGoogle Scholar
  4. 4.
    Green DF, McGuire EJ, Lytton B. A comparison of endoscopic suspension of the vesical neck versus anterior urethropexy for the treatment of stress urinary incontinence.J Urol 1986; 136:1205–1207PubMedGoogle Scholar
  5. 5.
    Pow-Sang JM, Lockhart JL, Suarez A, Lansman H, Politano VA. Female urinary incontinence: preoperative selection, surgical complication and results.J Urol 1986; 136:831–833PubMedGoogle Scholar
  6. 6.
    Richardson DA, Bent AE, Ostergard DR. The effect of uterovaginal prolapse on urethrovesical pressure dynamics.Am J Obstet Gynecol 1983; 146:901–905PubMedGoogle Scholar
  7. 7.
    Pereyra AJ, Lebherz TB. The revised Pereyra procedure. In: Buschbaum HJ, Schmidt JD, eds. Gynecologic and obstetric urology. Philadelphia: WB Saunders, 1978; 208–222Google Scholar
  8. 8.
    Raz S. Modified bladder neck suspension for female stress incontinence.Urology 1981; 17:82–85PubMedGoogle Scholar
  9. 9.
    Mundy AR. A trial comparing the Stamey bladder neck suspension procedure with colposuspension for the treatment of stress incontinence.Br J Urol 1983; 55:687–690PubMedGoogle Scholar
  10. 10.
    Pereyra AJ. A simplified surgical procedure for the correction of stress incontinence in women.West J Surg 1959; 67:223–226PubMedGoogle Scholar
  11. 11.
    Gittes RF, Loughlin KR. No-incision pubovaginal suspension for stress incontinence.J Urol 1987; 138:568–570PubMedGoogle Scholar
  12. 12.
    Sexton GL. The epiurethral suprapubic vaginal suspension (ESVS) for surgical correction of stress urinary incontinence. In: Slate WG, ed. Disorders of the female urethra and urinary incontinence. Baltimore: Williams and Wilkins, 1978; 160–173Google Scholar
  13. 13.
    Dunton CJ. Epiurethral suprapubic vaginal suspension: a report on 52 cases.Obstet Gynecol 1988; 71:945–948PubMedGoogle Scholar
  14. 14.
    Weil A, Reyes H, Bischoff P, Rottenberg RD, Krauler F. Modification of the urethral rest and stress profile after different types of surgery for stress incontinence.Br J Obstet Gynaecol 1984; 91:46–55PubMedGoogle Scholar
  15. 15.
    Bhatia NN, Bergman A. Modified Burch versus Pereyra retropubic urethropexy for stress incontinence.Obstet Gynecol 1985; 66:255–261PubMedGoogle Scholar
  16. 16.
    Bergman A, Ballard CA, Koonings PP. Comparison of three different surgical procedures for genuine stress incontinence: prospective randomized study.Am J Obstet Gynecol 1989; 160:1102–1106PubMedGoogle Scholar

Copyright information

© The International Urogynecology Journal 1991

Authors and Affiliations

  • D. A. Richardson
    • 1
  1. 1.Department of Obstetrics and GynecologyWayne State University, Hutzel HospitalDetroitUSA

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