Needle suspension procedures for urinary stress incontinence: a review and historical perspective.

Armand J. Pereyra introduced a new approach in the treatment of female urinary stress incontinence which did not require abdominal retropubic dissection. This operation and subsequent modifications by Pereyra serve as the foundation for various needle suspension procedures. The reported cure rates for the Modified Pereyra Procedure and its variations have exceeded 85 per cent in several studies. There has been some suggestion of an increased late failure rate in the Modified Pereyra Procedure compared to abdominal retroubic urethropexy. Additional long-term studies are needed to answer this important question utilizing preoperative and postoperative urodynamic evaluation. Karram and Bhatia in their review of transvaginal needle bladder neck suspension procedures cited three studies which accomplished this in a total of 60 patients. It seems the popularity of needle suspension procedures continues to grow. Increasingly, needle suspension procedures have been used in the outpatient treatment of urinary stress incontinence. A continuing tribute to the operative contributions of Armand J. Pereyra in the treatment of urinary stress incontinence.