ULP (urethral ligament plication) and midurethral sling: identical
anatomical pathways for cure of stress incontinence
Abstract
The ULP (urethral ligament plication) operation for stress urinary
incontinence is based on the same anatomical etiopathogenesis as the
midurethral sling (MUS): restoring collagen to weakened PULs
(pubourethral ligaments), albeit, by plication with collagenopoietic
wide-bore polyester sutures to prevent PUL elongation under stress.
Calculated collagenopoietic sufficiency of polyester sutures came from a
doctoral thesis where collagen strength from a rejected polyester graft
was tested. Precise placements of the single polyester suture to PUL
were based on a live anatomical study. 12-month cure rate was 83%
(learning curve included), with no post-operative urinary retention, due
to absence of suburethral tapes.