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Urethral ligament plication operation (ULP) for minimal invasive cure of SUI without tapes
Ahmet Akın SİVASLIOĞLU1, Firangiz MIRZAZADA2, Ray HODGSON3, Peter PETROS41Private Clinic, Head of Obstetrics and Gynaecology Department, İzmir, Türkiye, 2Clinic of Obstetrics and Gynaecology, Denizli Cerrahi Hospital, Denizli, Türkiye, 3Department of Obstetrics and Gynaecology, University of New South Wales, Sydney, Australia, 4University of Western Australia School of Mechanical and Mathematical Engineering, Perth WA, Australia
Objectives: To present 12-month data of the urethral ligament plication (ULP) operation for cure of stress urinary incontinence (SUI). Materials and Methods: Thirty-six women, mean age 58.6 years from two centres underwent the ULP operation. Operation: Two full thickness parallel incisions in the vaginal sulcus were made, extending from bladder neck to urethral meatus. The incision was opened out to reveal external urethral ligament and both branches of pubourethral ligaments, which were plicated with no 2 or 3 polyester sutures. The vaginal incisions were closed with polyglactin sutures. The 36 women constitute the learning curve of the surgeons. Inclusion criterion: Demonstrated urine loss on coughing controlled by a hemostat at midurethra. Exclusion criteria: None. Criterion for cure: No urine on coughing with a full bladder. Results: All women were discharged the of day of surgery. Six-month results 31/36 women (86%) were cured of SUI. Twelve-month results 29/35 women (83%) remained cured of SUI. Conclusion: The 12-month data is encouraging, especially as it included the learning curve of the authors. Minimum deterioration in SUI cure from 6 to 12 months suggested ongoing new collagen formation in response to the polyester sutures. Absence of tapes and tape related complications has much to recommend this new direction for SUI surgery. The ULP is a low-cost, low-resource operation which requires only moderate skills, and is especially suitable for the developing world. However, further well-monitored studies by other surgeons will be required before this operation can be recommended for general use.
Cite This Article
SİVASLIOĞLU A, MIRZAZADA F, HODGSON R, PETROS P. Urethral ligament plication operation (ULP) for minimal invasive cure of SUI without tapes. 2024; 43(1): 25-29
Corresponding Author: SİVASLIOĞLU A.
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