Abstract
Aims/objectives: Although both the tension-free vaginal tape (TVT) and the transobturator suburethral tape (TOT) have a high success rate in the treatment of stress urinary incontinence (SUI), both techniques have complications. In this study, we investigated the hypothesis that the approximation of the two ischiocavernosus muscles (ICMs) over the mid-urethra would effect a cure for the SUI. Methods: The technique was performed in 68 women with SUI who had a mean age of 54.3 ± 11.2 years. Inclusion criteria was comprised of a clinical and urodynamic diagnosis of SUI, a positive stress test, and a cystoscopy procedure. A transverse incision was performed below the external urethral orifice. The flaps of the incision were undermined laterally to expose both ICMs. The exposed ICMs and the underlying crus clitoridis (CC) were approximated and sutured together over the exposed mid-urethra. Results: A cure of SUI was achieved in 64 patients (94.1%). Four failures were the result of a gaping of the suture line; a resuturing of the two ICMs effected a cure in these 4 patients. No patient had a urethral erosion or urinary retention during a mean follow-up period of 28.6 ± 11.2 months. Conclusions: The ischiocavernosus perineorrhaphy procedure is a new, simple, and easy outpatient option for the treatment of SUI. Compared with the sling operations in currently common use, this procedure appeared to be equally effective but had less complications.
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