Outcome of Syed’s Modified Pubo-Vaginal Fascial Rectus Sling Surgery in The Treatment of Female Urinary Incontinence - A Single Centre Experience

Abstract

Original Research Article Objective: We Modified the technique of pubo-vaginal fascial rectus sling to make it minimally invasive, less expensive and reduce the incidence of post operative urinary dysfunction. Material and Methods: This study was conducted over a period of ten years on 147 patients who were operated from Jan 2003 to Jan 2013, and followed till Jan 2020. Female patients with age range from 25-65yrs, having SUI were included in the study. Apart from the standard operative procedure of PVS, we have developed a modification in which once the prolene threads are passed above from the vaginal wound, they are not tied together as per the standard procedure but a Hemolok clip (10mm) was used bilaterally to secure the thread over the rectus sheath. Results: Operation was performed in general as well as in regional block. Mean operative time was 45 min with average blood loss of 100 ml. Average Sling length was 10cm with a width of 2cms. Hemolok clips (10mm) were used at both ends over the rectus sheath after appropriate tension. Hospital stay was 2.4 days. Minor Complications occur in 17 pts (11.5%). Till Jan 2020, 131pts (89.11%) are voiding well & have no leakage or retention, while rest of the patients 16 (10.88%) are lost to follow up after 3 years. Conclusion: Syed ' s Modified Pubovaginal fascial rectus sling is a highly successful strategy for the management of Female urinary incontinence with a low rate of postoperative voiding dysfunction with good long term functional & cosmetic results.