Aybüke TAYARER, Filiz DİŞÇİ
Pelviperineology - 2025;44(3):103-108
Objective: To evaluate the short-term outcomes of urethral ligament plication (ULP) with a midline approach as a minimally invasive surgical option for the treatment of stress urinary incontinence (SUI). Materials and Methods: This retrospective study included 23 women diagnosed with SUI who underwent ULP using a midline vaginal approach. A single non-absorbable polyester suture was placed through the lateral arms of the pubourethral ligament and tied beneath the urethra. The primary outcome measure was the cough stress test performed postoperatively on day 7 and day 30. Operative time, hospital stay, and development of complications were also recorded. Results: At postoperative day 7, 16 patients (69.6%) had a negative cough stress test, while 7 (30.4%) remained positive. At day 30, continence was achieved in 17 patients (73.9%), with 6 patients (26.1%) testing positive. The mean operative time was 37.4+/-5.7 minutes, and the mean length of hospital stay was 1.26+/-0.45 days. No major intraoperative complications occurred. Conclusion: The midline approach to ULP demonstrated promising short-term outcomes in the treatment of SUI, with continence rates comparable to previously reported paraurethral techniques. The procedure is simple, mesh-free, and appears safe; however, these findings are based on a pilot series and further studies with larger cohorts and long-term follow-up are required to confirm its efficacy and durability.
