Methods:
We conducted prospective evaluation of patients with bothersome stress
urinary incontinence who underwent laparoscopic mid-urethral autologous
rectus fascial sling insertion (LMAFS). We included women 18 years of
age or older, who had predominant symptoms of stress urinary
incontinence, who failed conservative treatment. All patients filled the
International Consultation on Incontinence Questionnaire-Urinary
Incontinence Short Form (ICIQ-SF) questionnaire pre and post
operatively. On examination, all patients had positive cough test,
defined as leakage of urine with bladder filled to least 300 ml of urine
(measured by ultrasound bladder volume evaluation). All patients had
hypermobile bladder neck and urethra on coughing or maximum valsalva.
All patients underwent urodynamic evaluation by multi-channel
cystometry. All patients had urodynamic stress incontinence, with normal
voiding and no evidence of detrusor overactivity. Post operatively,
patients filled the Patient Global Impression of Improvement
Questionnaire (PGII)5 and the ICIQ-SF. Success was
defined as response of “very much better” or “much better” on PGII.
All other responses were considered treatment failure. Institutional
review board (IRB) approval was obtained prior to study, and informed
consent was obtained from each participant.