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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