The vaginal wall sling: A compressive suspension procedure for recurrent incontinence in elderly patients

Objective. To determine the efficacy of the vaginal wall sling in the management of recurrent stress urinary incontinence (SUI) in an elderly female population. Method. Eighteen elderly female patients (average age 68.4 years) with recurrent stress urinary incontinence were studied with a thorough evaluation including videourodynamics. Thirteen patients were diagnosed with type III SUI and 5 patients had type II SUI. A description of the technique, first described by Raz, is provided. Results. Follow-up ranged from six to forty-two months (average 18 months.) All patients are completely dry and express satisfaction with their outcome. Seventeen of 18 patients (94%) are voiding spontaneously. One patient at twelve months' postoperation requires clean intermittent catheterization. Conclusion. Many elderly female patients with recurrent stress urinary incontinence have intrinsic urethral sphincteric incompetence as well as recurrent hypermobility that often classifies them as type II SUI. The vaginal wall sling addresses both problems and is a safe, simple, and effective procedure in the management of recurrent incontinence in elderly female patients.