METHOD FOR CORRECTION OF STRESS URINARY INCONTINENCE (VERSIONS) Russian patent published in 2024 - IPC A61B17/42 A61F2/02 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to urology. Synthetic mesh prosthesis is installed by vaginal colposuspension by means of a transobturator and retropubic approach. Foley catheter 18 Ch is inserted into the bladder, and a median incision of the anterior wall of the vagina is made 1.5 cm long, at distance of 1 cm from the external opening of the urethra. Transobturator approach involves forming canals in the paraurethral tissues in the direction of the posterior surface of the inferior pubic branches. Mesh synthetic prosthesis is implanted along the formed channels into the paraurethral space by means of trocars towards the obturator membranes; the mesh synthetic prosthesis is dissected under the urethra along the midline and fixed with an absorbable material to the anterior wall of the vagina on both sides: lateral to the urethra and to the periurethral fascia at the level of the middle one-third of the urethra, while the area under the urethra remains intact. Thereafter, the ends of the mesh synthetic prosthesis are brought out through skin incisions in a projection of the superior medial edge of the obturator membrane. Retropubic approach involves forming canals in the paraurethral tissues towards the posterior surface of the superior pubic branches. Mesh synthetic prosthesis is implanted through the formed canals into the paraurethral space by means of trocars by the pubic articulation. Under the urethra, the mesh synthetic prosthesis is dissected along the midline and fixed with an absorbable material to the anterior vaginal wall from both sides: lateral to the urethra and to the periurethral fascia at the level of the middle one-third of the urethra, while the area under the urethra remains intact. Thereafter, the ends of the mesh synthetic prosthesis are brought out through the skin incisions in a projection behind the pubic articulation. Vaginal defect is repaired with a Donati suture. Tampon is inserted into the vagina, which is removed together with the Foley catheter on 1st postoperative day, followed by performing cough tests and measuring the volume of residual urine.

EFFECT: method is highly effective, minimally invasive, enables reducing the rate of complications associated with the prosthesis tension on the urethra, as well as reducing the rate of protrusion of the synthetic mesh prosthesis into the urethral lumen.

2 cl, 2 dwg, 2 ex