Stress urinary incontinence. Laparoscopically assisted transvaginal needle suspension.
OBJECTIVE
To characterize laparoscopically assisted transvaginal needle suspension for stress urinary incontinence and describe the authors' initial experience with this approach.


METHODS
A retrospective analysis was performed on 19 cases of stress urinary incontinence treated with this technique. All patients were evaluated at least one year postoperatively.


RESULTS
Laparoscopically assisted transvaginal needle suspension was successfully completed in all 19 cases. No procedure required conversion to laparotomy. No intraoperative morbidity attributable to prevesical dissection was noted. Average operating time for needle suspension was 25 minutes, and average blood loss was 50 mL. No postoperative infectious or hemorrhagic morbidity was noted. All patients were subjectively cured of incontinence one year postoperatively, although two patients experienced transient urinary retention, and one experienced transient detrusor instability within the first three postoperative months.


CONCLUSIONS
This approach allows accurate, visually guided placement of suspension sutures and may induce extraperitoneal scarring similar to retropublic colposuspension. These factors may result in long-term cure rates comparable to those of retropublic colposuspension without the need for endoscopic suturing.
Pelosi
M A
MA
Pelosi Women's Medical Center, Bayonne, NJ 07002, USA.
Pelosi
M A
MA
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*