Transfascial vaginal tape for surgical treatment of stress urinary incontinence

IntroductionIn the past decade, two minimally invasive, mid-urethral sling procedures have been developed to correct stress urinary incontinence: the tension-free vaginal tape and the transobturator tape. Using similar surgical principles, we describe the placement of a sling located at the mid-urethral level and placed laterally in the previously perforated endopelvic fascia. This technique was termed transfascial vaginal tape.Technical ConsiderationsA 2 to 3-cm-long vertical incision was made at the mid-urethral level. A suburethral tunnel was created bilaterally in the anterior vaginal wall until the endopelvic fascia and retropubic space were reached. A 1.5 × 8-cm monofilament polypropylene mesh was placed under the mid-urethra and laterally in the previously perforated endopelvic fascia. Bilaterally, the sling was sutured to the urethropelvic ligaments.ConclusionsWe describe a new, simple, safe, minimally invasive, tension-free, and cost-effective technique for the treatment of female stress urinary incontinence.