Evaluation of a minimal-incision pubovaginal suspension as an adjunct to other pelvic-floor surgery.

In September 1987, Gittes and Loughlin first described a minimal-incision pubovaginal suspension as a modification of the Pereyra needle suspension urethropexy. Thirty-four women who underwent the minimal-incision urethropexy procedure were studied for up to 13 months postoperatively. Although 21 patients also had the anterior vaginal wall opened to perform concomitant pelvic-floor surgery, the principles of minimal suprapubic incision, full-thickness vaginal sutures, and no dissection of endopelvic fascia were followed strictly in all 34 cases. With a mean follow-up of 9.5 months, the objective cure rate was 91% and subjectively, 97% of the patients were either cured or improved. This technically simpler procedure is effective for treating genuine stress urinary incontinence in women who also require surgical repair of other pelvic-floor defects.