V13-07 STANDARDIZED TENSIONING TECHNIQUE FOR AUTOLOGOUS PUBOVAGINAL SLINGS

Abstract

You have accessJournal of UrologyFemale Pelvic Surgery (V13)1 Apr 2020V13-07 STANDARDIZED TENSIONING TECHNIQUE FOR AUTOLOGOUS PUBOVAGINAL SLINGS Alan Quach*, Michael Maccini, David Koslov, Kirk Redger, and Brian Flynn Alan Quach*Alan Quach* More articles by this author , Michael MacciniMichael Maccini More articles by this author , David KoslovDavid Koslov More articles by this author , Kirk RedgerKirk Redger More articles by this author , and Brian FlynnBrian Flynn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000970.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recent FDA public health notifications have created increased utilization of autologous pubovaginal slings (PVS). Unlike midurethral slings, there is no standardization in tensioning methods of autologous fascial slings, leading to increased rates of postoperative urinary retention (10%). Consequently we have made efforts to standardize our technique to lesson the risk of retention in this population. METHODS: Since 2013, we have adopted a standardized tensioning technique. Briefly, a rubber shod is placed on the suspension sutures at the level of the fascia bilaterally. A second rubber shod is placed at a defined distance above the fascia and the suspension sutures are tied. This predetermined distance is as follows: 0 cm spacing for occlusive slings, 1 cm spacing for patients with severe ISD, and 2 cm spacing for the remaining population. In this video we will demonstrate autologous rectus fascial harvest and our standardized rubber shod tensioning technique in a 53 year old female with recurrent stress urinary incontinence following removal of exposed transvaginal mesh. RESULTS: In 168 patients, our overall SUI cure rate (<1 pad per day) was 78%. The standardized tensioning group had a decreased risk of both postoperative retention and sling lysis (OR = 0.41 and 0.22, respectively). Increasing surgeon experience did not demonstrate an independent association with postoperative retention. CONCLUSIONS: Our standardized tensioning technique for autologous PVS reduces the risk of postoperative retention and sling lysis while maintaining excellent continence outcomes. This technique offers reproducible tensioning which could reduce the learning curve for autologous PVS procedures. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1212-e1212 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alan Quach* More articles by this author Michael Maccini More articles by this author David Koslov More articles by this author Kirk Redger More articles by this author Brian Flynn More articles by this author Expand All Advertisement PDF downloadLoading ...