RESUMO
One of the female problems, especially with aging and multiparity, is stress urinary incontinence. This can be treated with medical or surgical ways. Nowadays, minimal invasive techniques have some adherents. In this article we give the results of the I.V.S, technique. Since 2002 to 2004,135 patients with S.U.I, referred to our clinic. 72 patients had S.U.I, and 21 had M.U.I, with S.U.I, prodominency. We did not do this procedure for patients with grade 2 or 3 cystocele. In brief, 14 patients 28-65 years old [average: 42] were treated with I.V.S technique.6 patients had the history of colporaphy because of S.U.I. Before surgery we asked the patients for the history, ph.exm. and did routine exams,heart consult, renal and bladder sonography and P.V.R. In lithotomy position and with local anesthesia we did cystoscopy and marshal test and if positive, under spinal anesthesia we did anterior vaginal incision from bladder neck to midurethra. Then we dissected mucous from under layer and perforated endopelvic fascia and release of the retropubic space and placed special tape in midurethra portion. Tension on the tape protected from leak at the time of the increased intra abdominal pressure or a little leak. After that we repaired vaginal mucosa and placed catheter and vaginal mesh. Patients had complete bed rest for 1 day, and we removed the catheter, and after that the patients voided. There was no mortality in this procedure. In 1 patient the urethra was perforated, and we repaired it in. 3 layers. Tape was placed replaced, and the catheter was in place for 10 days. There is no retention or dysparonia. In 1 patient we had U.T.I. that was treated with antibiotics. We did sonography and P.V.R. after 1 month that was less than upper limits of the normal in all r/patients. This technique is simple with short time anesthesia. We can use I.V.S. for 2 kinds of S.U.I. [hypermobility or I.S.D.] and this procedure is recommended for patients without cystocele or grade 1 cystocele because of low complications, good results, and effectiveness