No abstract

No abstract

IntroductionA novel native tissue midurethral support procedure, Levator Ani Midurethral Support via single vaginal incision, to treat patients with stress urinary incontinence is introduced in this case report. After mesh controversy, there is a need for a minimal invasive native tissue surgical procedure to treat stress urinary incontinence with minimal complication.Case PresentationA 51-year-old female with stress urinary incontinence had three mesh midurethral slings and one autologous fascia sling with severe infection that failed. She developed recurrent stress urinary incontinence and coital incontinence. After she was referred to our care, she was initially treated with urethral bulking injections which also failed. There were few alternatives left after failure of three mesh midurethral slings, one autologous fascia sling with severe infection and urethral bulking injections. The patient was successful treated with our novel native tissue midurethral support procedure, Levator Ani Midurethral Support via single vaginal incision. She remains continent 23 months after the Levator Ani Midurethral Support via single vaginal incision and her coital incontinence has also resolved. She reported she has no pelvic pain or dyspareunia. ConclusionsAfter further study, this novel native tissue midurethral support procedure, Levator Ani Midurethral Support via single vaginal incision may meet the need for a minimal invasive native tissue surgical procedure for the treatment of stress urinary incontinence with minimal complication.

This proof-of-concept investigation reports the results of eight patients who, after declining mesh midurethral slings, were treated for stress urinary incontinence with levator ani midurethral support, a single vaginal incision technique. Seven patients had good subjective outcomes at 22 to 33 months. One patient had good subjective outcome for 14 months, followed by stress urinary incontinence recurrence. The peri-operative complications were temporary urinary retention at hospital discharge and urinary tract infection. Patients reported having no long-term complications. Results of this preliminary investigation suggest that this technique may be a reasonable alternative to other surgical procedures for stress urinary incontinence.