New hammock hypothesis-based method for the treatment of stress urinary incontinence : the first 29 urethral supports with a small fascial patch

Abstract Aim We have developed a new method requiring no manipulations of the retropubic passages, and carried out a retrospective study to assess the effectiveness, safety and early results of this new procedure in the treatment of female stress urinary incontinence. Methods From January 2001 to September 2003, 29 patients underwent our new surgery for the treatment of SUI. A 3 × 2 cm vertical rectangle was harvested from the rectus fascia. A convex horizontal incision was made over the mid urethra and bladder neck. The retropubic space was entered to the urethropelvic ligament spreading toward the junctions between urethropelvic ligament and tendinous arc. One suture was made at the point lateral to the bladder neck. Another suture was made behind the pubic bone. These two sutures were sutured again and tied with the short side end of the harvested fascia. The same procedure was performed on the other side. Results Of 29 patients, 26 (89.7%) were cured of stress urinary incontinence and 3 were improved. None of the patients had difficulty in voiding after the operation. Maximum flow rates were almost the same before and after surgery. None of the patients had any adverse events. Conclusion This procedure, which requires no manipulations of the retropubic passages, is safe and effective for the treatment of stress urinary incontinence.