V2-04: Rectus fascia spiral sling (RFSS) technique for women with multiple failed stress incontinence surge

V2-04: Rectus fascia spiral sling (RFSS) technique for women with multiple failed stress incontinence surgery due to severe intrinsic sphincteric deficiency

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Introductions and Objectives
Severe intrinsic sphincter deficiency (ISD) is a common cause of failed stress urinary incontinence (SUI) surgery. Management of women with multiple failed surgeries is particularly challenging, and these women are candidates for artificial sphincter implantation or continent urinary diversion. We present our experience with rectus fascia spiral sling (RFSS) in women with treatment-refractory ISD.

Methods
Four women (age: 19-64) underwent RFSS between 2011-2014. All women had severe incontinence with minimal activity or a slight change in body position. All had undergone multiple (range: 2-5) surgeries for SUI. Clinical evaluation included subjective assessment with ICIQ-SF questionnaire, pelvic physical examination, and urodynamic studies. All patients demonstrated marked ISD with a valsalva leak point pressure