Christopher Jayne

Oregon Health & Sciences University, USA

Title: Retropubic Sling Placement with C-clamp Technique

Abstract

Importance: Synthetic mesh midurethral slings have become the criterion-standard treatment for stress urinary incontinence with urethral hypermobility in women. Iatrogenic bladder bowel and urethral injury are known risk of the procedure. Urinary retention and incomplete bladder emptying are known post operative risks.

Objective: Our objective was to show that a novel “C-clamp technique” can significantly reduce the risk of bladder and urethral injury at the time of bottom-up retropubic synthetic mesh midurethral sling placement. Our secondary objective was to significantly reduce the risk of bowel injury, urinary retention and incomplete bladder emptying post operatively.

Study Design: We conducted a retrospective review of the electronic medical records using Current Procedural Terminology coding of a single surgeon who performed synthetic mesh midurethral slings. Medical records were reviewed for demographic and clinical data for all bottom-up retropubic synthetic mesh midurethral slings placed using a novel C-clamp technique. All operative reports were reviewed for bladder and urethral injury at the time of implantation of the synthetic mesh midurethral sling using the C-clamp technique. Anecdotally the cases were reviewed for bowel injury, urinary retention and incomplete bladder emptying.

Results: Three hundred fourteen consecutive bottom-up retropubic synthetic mesh midurethral slings were placed using the C-clamp technique from April 2012 through October 2023. The average age was 52 years (29–86 years); the average weight was 81 kg (46 -149 kg); and the average body mass index was 31 kg/m2 (15–57 kg/m2). No patients sustained a bladder or urethral injury at the time of implantation of a retropubic synthetic mesh midurethral sling using the C-clamp technique. No patients sustained a bowel injury, urinary retention or incomplete bladder emptying.

Conclusion: The novel C-clamp technique shows promise in eliminating the common risk of implanting a bottom-up retropubic synthetic mesh midurethral sling.

Biography

Christopher Jayne received his BSc with honors from the State University of New York at Albany and his medical degree with honors from the State University of New York Buffalo School of Medicine. He completed his residency in Obstetrics and Gynaecology, at Baylor College of Medicine in Houston Texas. He went on to complete a fellowship in Female Urology and Voiding Dysfunction at the Scott Department of Urology at Baylor College of Medicine and Vanguard Urologic Institute in Houston. He founded Greater Houston Urogyn, focusing on Urogynaecology and minimally invasive complicated gynaecological surgery. He is uniquely qualified and is the only physician in the world fellowship trained and certified in Obstetrics and gynaecology, Urogynaecology and Reconstructive Pelvic Surgery, Minimally Invasive Gynaecologic Surgery and Sexual Health. He has extensive experience in the surgical management of urinary incontinence in women and has developed novel techniques to treat women with urinary incontinence.

2nd International Conference on Gynecology and Obstetrics

Christopher Jayne

Title: Retropubic Sling Placement with C-clamp Technique

Abstract

Biography

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