Abstract
Stress urinary incontinence (SUI) in the female may be treated by a variety of non-surgical and surgical therapies. However, once the patient has chosen to undergo operative repair the ideal procedure is based on three considerations: the degree of anterior vaginal wall prolapse, the degree of incontinence and associated anatomic abnormalities requiring surgical repair. In the vast majority of cases vaginal wall sling is our procedure of choice for the surgical treatment of SUI in the female. Vaginal wall sling is based on sound anatomic principles, may be performed as an outpatient procedure and is equally efficacious for the treatment of SUI due to anatomic incontinence (urethral hypermobility) and intrinsic sphincter deficiency. Since vaginal wall sling is performed through a transvaginal approach, other associated manifestations of pelvic floor prolapse such as rectocele can be addressed and repaired simultaneously. When necessary the vaginal wall sling can be easily modified to repair large grade cystoceles.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chapple CR, Helm CW, Blease S, Milroy EJ, Rickards D, Osbourne JL (1989) Asymptomatic bladder neck incompetence in nulliparous females. Br J Urol 64: 357–359
Chopra A, Raz S, Stothers L (1996) Pathogenesis of cystoceles — anterior colporrhaphy. In: Raz S (ed) Female urology, 2nd edn. Saunders, Philadelphia, pp 338–357
Dupont MC, Albo ME, Raz S (1996) A videourodynamic evaluation of bladder neck competence in females. J Urol 155: 536A
Juma S, Little N, Raz S (1992) Vaginal wall sling: four years later. Urology 34: 424–428
Klutke C, Golomb J, Barbaric Z, Raz S (1990) The anatomy of stress incontinence: magnetic resonance imaging of the female bladder neck and urethra. J Urol 143: 563–566
McGuire EJ (1995) Urodynamic evaluation of stress incontinence. Urol Clin North Am 22: 551–555
Monga M, Ghoniem GM (1994) Ilioinguinal nerve entrapment following needle bladder suspension procedures. Urology 44: 447–450
Nitti VW, Bregg KJ, Sussman EM, Raz S (1993) The Raz bladder neck suspension in patients 65 years and older. J Urol 149: 802–807
Raz S (1981) Modified bladder neck suspension for female stress incontinence. Urology 17: 82–85
Raz S, Erickson DR (1992) SEAPI QMN incontinence classification system. Neurourol Urodyn 11: 187–199
Raz S, Siegel AL, Short JL, Snyder JA (1989) Vaginal wall sling. J Urol 141: 43–45
Raz S, Klutke CG, Golomb J (1989) Four corner bladder and urethral suspension for moderate cystocele. J Urol 142: 712–715
Raz S, Little N, Juma S, Sussman E (1991) Repair of severe anterior vaginal wall prolapse (grade IV cystourethrocele). J Urol 146: 988–992
Raz S, Sussman EM, Erickson DB, Bregg KJ, Nitti VW (1992) The Raz bladder neck suspension: results in 206 patients. J Urol 148: 845–850
Raz S, Stothers L, Young GPH, Short J, Marks B, Chopra A, Wahle G (1996) Vaginal wall sling for anatomical incontinence and intrinsic sphincter dysfunction: efficacy and outcome analysis. J Urol 156: 166–170
Raz S, Stothers L, Chopra A (1996) Raz techniques for anterior vaginal wall repair. In: Raz S (ed) Female urology. Saunders, Philadelphia
Stothers L, Raz S (1995) The anatomy of female continence. Paper presented at the meeting of the American Urological Association, Western Section, Scottsdale, Arizona, November 5–9
Versi E, Cardozo LD, Studd JW, Brincat M, O'Dowd TM, Cooper DJ (1986) Internal urinary sphincter in maintenance of female continence. BMJ 292: 166–167
Wahle GR, Young GPH, Raz S (1996) Anatomy and pathophysiology of pelvic support. In: Raz S (ed) Female urology, 2nd edn. Saunders, Philadelphia, pp 57–72
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rovner, E.S., Ginsberg, D.A. & Raz, S. The UCLA surgical approach to sphincteric incontinence in women. World J Urol 15, 280–294 (1997). https://doi.org/10.1007/BF02202013
Issue Date:
DOI: https://doi.org/10.1007/BF02202013