Retropubic vaginopexy for correction of urinary stress incontinence.

One of the most important principles of surgical correction of urinary stress incontinence is the restoration of the urethrovesical angle to its original anatomic position. A new variant of urethropexy, suspending the vaginal wall from the anterior rectus fascia, is presented. To accomplish this goal, a special ligature carrier needle was designed. The ligatures are carried with this needle from the vaginal wall, through the space of Retzius, and upward above the rectus fascia where they are tied across the midline, one side to the other. This report describes the new method in detail. Using this technique, urethropexy was performed on 98 patients at the UCLA Olive View Medical Center. The overall cure rate for urinary stress incontinence was over 95% at 6-months to 3-year follow-up. The most common complications were postoperative urinary retention and urinary tract infection. The average length of hospitalization was 5 days.