The Raz Bladder Suspensions: Treatment of Stress Urinary Incontinence: 10 Years Personal Experience

Abstract

Introduction: We report on one surgeon's clinical experience with the 2 and 4 corner Raz bladder suspension performed for the treatment of stress urinary incontinence (alone or associated with cystocoele repair) in a consecutive patient cohort between 2003 and 2012 reporting short and longer term results. Materials and Methods:We performed a retrospective study of consecutive patients who underwent a 2 or 4 corner Raz bladder suspension by one surgeon (EHA ) to treat stress urinary incontinence over a period of time from Jan 1 2003 -Sept 2012. 3 month and longer term outcomes was determined by patient self assessment including validated questionnaires.Results: 98.7% of 82 patients reported no stress incontinence at 3 months Longer term follow-up was available on 48 (65%) patients. Of those lost to follow up, 8 were deceased. Mean age was 66.1 years. Mean follow up was 48.2 months (range 4-111months). 21 of the 48 (44%)patients were beyond 48 months. 41 of 48 (85%) patients were either delighted, pleased or mostly satisfied. 42 of 48 patients (87.5 %) had 50 % or more improvement. Pad use of 2.6 decreased to 0.9 pads with P value less than 0.0001. Conclusion:The Raz bladder suspension has good short and longer term results in relieving stress incontinence in addition to low morbidity and lower costs without the use of any mesh product.

Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique

“…Agatstein and Shlomo Raz in their published series of 82 patients performed four-corner Raz procedure in 33 patients with grade I to III cystocele but did not analyze the success rate in terms of recurrent prolapse of anterior vaginal wall. 2 Miyazaki et al in a study of 27 patients with severe cystocele who underwent four-corner Raz procedures did not find satisfactory results for severe cystocele on long-term follow-up of 4 years. Failure rate was 59%.…”

“…This can be done as an isolated procedure or may be combined with vaginal hysterectomy or anterior and posterior repair. 2 However, the Raz two-corner suspension technique was used for the treatment of SUI only. Since the last 15 years, sling surgery has replaced Raz procedure for the treatment of SUI.…”