African Journal of Urology

, Volume 17, Issue 1, pp 1–5 | Cite as

Rolled vaginal wall flap for the treatment of stress urinary incontinence

  • M. Shoukry
  • Mohamed E. HassounaEmail author
  • A. AbdEl-Kerim
  • S. El-Salmy
Original Article



Anterior vaginal wall slings (AVWS) have been used for decades in the treatment of female stress urinary incontinence (SUI). The main drawback of using the vaginal wall as a sling is its tendency to weaken and stretch over the course of years. The use of synthetic tapes for the treatment of SUI is effective but costly. For patients who cannot afford synthetic tapes, we describe the preliminary results of a modi and III.

Patients and Methods

In this series, a modification of the AVWS was applied in 35 female patients with SUI. A fortified and rolled urethra. The vaginal mucosal surface of the across it. The flap is then rolled on itself with a running 2/0 vicryl suture. Two sutures attached to both ends are passed retropubically to the anterior abdominal wall and tied over the rectus sheath.


All 35 female patients had type II/III SUI. After a median follow up of 43 months, 91% of the patients were dry or used 0–1 pad per day. Only one patient suffered from transient retention for one week post-operatively.


This is a simple method to reinforce vaginal wall effective option for the treatment of SUI in patients who can not afford synthetic tapes. Long-term follow up is required to evaluate the durability of the procedure.

Key Words

Stress urinary incontinence vaginal wall sling 


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  1. 1.
    Barber MD, Kleeman S, Karram MM, Paraiso MFR, Walters MD, Vasavada S, et al. Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: A randomized controlled trial. Obstet.Gynecol. 2008;111(3):611–621.PubMedCrossRefGoogle Scholar
  2. 2.
    Raz S, Siegel AL, Short JL, Snyder JA. Vaginal wall sling. J.Urol. 1989; Jan;141(1):43–46.PubMedGoogle Scholar
  3. 3.
    Vasavada SP, Rackley RR, Appell RA. In situ anterior vaginal wall sling formation with preservation of the endopelvic fascia for treatment of stress urinary incontinence. Int.Urogynecol.J.Pelvic Floor Dysfunct. 1998;9(6):379–384.PubMedCrossRefGoogle Scholar
  4. 4.
    Volkmer BG, Nesslauer T, Rinnab L, Schradin T, Hautmann RE, Gottfried HW. Surgical intervention for complications of tension-free vaginal tape procedure. J.Urol. 2003; Feb;169(2):570–574.PubMedCrossRefGoogle Scholar
  5. 5.
    Tsivian A, Kessler O, Mogutin B, Rosenthal J, Korczak D, Levin S, et al. Tape related complications of the tension-free vaginal tape procedure. J.Urol. 2004; Feb;171(2 Pt 1):762–764.PubMedCrossRefGoogle Scholar
  6. 6.
    Juma S, Little NA, Raz S. Vaginal wall sling: Four years later. Urology. 1992; May;39(5):424–428.PubMedCrossRefGoogle Scholar
  7. 7.
    Raz S, Stothers L, Young GP, Short J, Marks B, Chopra A, et al. Vaginal wall sling for anatomical incontinence and intrinsic sphincter dysfunction: Efficacy and outcome analysis. J.Urol. 1996; Jul;156(1):166–170.PubMedCrossRefGoogle Scholar
  8. 8.
    Litwiller SE, Nelson RS, Fone PD, Kim KB, Stone AR. Vaginal wall sling: Long-term outcome analysis of factors contributing to patients satisfaction and surgical success. J.Urol. 1997; Apr;157(4):1279–1282.PubMedCrossRefGoogle Scholar
  9. 9.
    Su TH, Huang JP, Wang YL, Yang JM, Wei HJ, Huang CL. Is modified in situ vaginal wall sling operation the treatment of choice for recurrent genuine stress incontinence? J.Urol. 1999; Dec;162(6):2073–2077.PubMedCrossRefGoogle Scholar
  10. 10.
    Goldman HB, Rackley RR, Appell RA. The in situ anterior vaginal wall sling: Predictors of success. J.Urol. 2001; Dec;166(6):2259–2262.PubMedCrossRefGoogle Scholar
  11. 11.
    Kilicarslan H, Gokce G, Ayan S, Guvenal T, Kaya K, Gultekin EY. Predictors of outcome after in situ anterior vaginal wall sling surgery. Int.Urogynecol.J.Pelvic Floor Dysfunct. 2003; Nov;14(5):339,41; discussion 341.PubMedCrossRefGoogle Scholar
  12. 12.
    Kaplan SA, Te AE, Young GP, Andrade A, Cabelin MA, Ikeguchi EF. Prospective analysis of 373 consecutive women with stress urinary incontinence treated with a vaginal wall sling: The Columbia-Cornell University experience. J.Urol. 2000; Nov;164(5):1623–1627.PubMedCrossRefGoogle Scholar
  13. 13.
    Rodrigues P, Hering F, Meler A, Campagnari JC, D’Império M. Pubo-fascial versus vaginal sling operation for the treatment of stress urinary incontinence: A prospective study. Neurourol.Urodyn. 2004;23(7):627–631.PubMedCrossRefGoogle Scholar
  14. 14.
    Metin A, Kayigil O, Ahmed SI, Atmaca AF. Is the efficacy of in situ vaginal wall slings decreasing in the late follow-up? Int.Urol.Nephrol. 2008;40(1):51–55.PubMedCrossRefGoogle Scholar
  15. 15.
    Mikhail MS, Rosa H, Packer P, Palan P, Lazarou G. A modified vaginal wall patch sling technique as a firstline surgical approach for genuine stress incontinence with urethral hypermobility: Long-term follow up. Int. Urogynecol.J.Pelvic Floor Dysfunct. 2004;15(2):132–137.PubMedCrossRefGoogle Scholar

Copyright information

© PAUSA and Springer Verlag France 2011

Authors and Affiliations

  • M. Shoukry
    • 1
  • Mohamed E. Hassouna
    • 1
    Email author
  • A. AbdEl-Kerim
    • 1
  • S. El-Salmy
    • 1
  1. 1.Department of Urology, Faculty of MedicineAlexandria UniversityAlexandriaEgypt

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