ICS 1999, Denver
Video presentations
Suburethral duplication and anterior colporrhaphy reinforced with a suburethral marlex mesh for the treatment of cystocoele and stress urinary incontinence or latent stress incontinence

Drutz, H.P.
Section of Urogynecology, Department of Obstetrics and Gynecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada

This 20 minute teaching video outlines a vaginal surgical approach to women with anterior wall prolapse and bladder neck hypermobility associated with overt or latent stress urinary incontinence. The surgical technique combines the use of wide double imbricating suture at the level of the urethrovesical junction, with a suburethral buttress formed by placing a T shaped piece of Marlex Mesh at the level of the urethrovesical junction, the arms of which are placed into tunnels that have been created up trough the urogenital diaphragm into the space of Retzius. The procedure is augmented by a suburethral duplication (Lazarevski Technique) which further elevates the UVJ. In this video vaginal hysterectomy, cystocoele, enterocoele and rectocoele repair, and sacrospinous vault suspension are also performed to correct all the pelvic floor problems and achieve a durable results.

Initial 2 year follow up of these patients indicates a 90 percent success ongoing rate in correcting pelvic floor prolapse and stress incontinence.

Source: 29 th International Continence Society Annual Meeting, August 22-26, 1999, Video Demonstration