Simplified surgical approach to bladder outlet obstruction following pubovaginal sling.

We report a new technique of vaginal patch interposition to relieve bladder outlet obstruction after a suburethral sling procedure when the obstruction is caused by over correction of the urethrovesical angle. In this technique the sling is incised longitudinally in the midline and dissected laterally. A vaginal patch is obtained from the vaginal mucosa, then interposed and sutured between the 2 cut edges of the sling. This method is characterized by simplicity and low morbidity, while preserving the integrity of the suburethral sling to maintain continence.