VIDEO ABSTRACT provides an anatomical summary of the PPP
operation. A technique for the pubourethral plication procedure (PPP)
with No3 polyester sutures for cure of stress urinary incontinence
without tapes via parallel sulcal incisions extending from bladder neck
to urethral meatus. Both branches of each pubourethral ligament were
sutured with No2 or 3 polyester sutures extending to the external
urethral ligaments and medial part of pubococcygeus; the vaginal
incisions closed with polyglactin sutures. All women were discharged of
day of surgery. Six month results Age :58.6
years;31/36 women (86%)were cured of SUI and 11/19 (58%) concomitant
urge. 5 surgical failures, 4 immediately post-operatively, and one at 3
months.
Our minimally invasive Fothergill-Manchester technique aims to decrease
blood loss and surgical trauma and to preserve function by1. Vaginal
conservation. 2. Cardinal (CL) and uterosacral (USL) ligaments plicated,
not severed. 3. Direct suture of vagina to cervix without Sturmdorf
sutures after cervical amputation. 4. Use of No2 polyester sutures to
create new collagen to reinforce the plicated ligaments.
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