Experience of the Raz Procedure for Stress Urinary Incontinence

Park, Phil Ah; Park, Yong Il

Abstract

We retrospectively evaluated the 20 patients who underwent the Raz operation for genuine stress urinary incontinence from January, 1993 to January, 1994. The mean periods of follow-up was 11.1+/-4.3 months. Four patients with grade I stress incontinence, twelve patients with grade II stress incontinence and four patients with grade III stress incontinence underwent the Raz bladder neck suspension. All patients had no previous anti-incontinence operation. Seventeen patients(85%) were cured, while two patients(10%) were significantly improved with only rare episodes of incontinence not requiring protection. One(5%) was failure. When the results were stratified by degree of incontinence preoperatively 4 of 4 patients(100%) with mild, 11 of 12(9l.7%) with moderate and 4 of 4(100%) with severe incontinence had a successful outcome. Namely, 95 percent of the patients were either cured or improved. The complications were not significant except temporary urinary retention of 2 to 20 days, there was no permanent urinary retention. The advantages of a needle suspension procedure, as compared with the abdominal retropubic techniques, include simplicity, less operative time, decreased postoperative morbidity, and a shorter hospital stay, because it avoids an extensive abdominal operation. In addition, the vaginal approach enables the surgeon to perform concomitant pelvic floor surgery for other conditions, such as cystocele, rectocele, enterocele, and uterine prolapse. Therefore, in a relatively short-term follow-up and a small group, Raz bladder neck suspension seems to be the ideal procedure for the woman presenting with stress urinary incontinence.