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ULP (urethral ligament plication) and midurethral sling: identical anatomical pathways for cure of stress incontinence
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  • Peter Petros,
  • Akin Ahmet Sivaslioglu,
  • Ray Hodgson,
  • Paulo Palma
Peter Petros
Pelvic Reconstructive Surgeon (Retired

Corresponding Author:[email protected]

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Akin Ahmet Sivaslioglu
Izmir University of Economics Medicalpoint International Hospital
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Ray Hodgson
University of New South Wales Port Macquarie Campus
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Paulo Palma
University of Campinas
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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.