Genuine stress urinary incontinence in women. New laparoscopic paravaginal reconstruction.
OBJECTIVE
To assess a new laparoscopic technique of paravaginal repair, adapted from a classic laparotomy procedure, for genuine stress urinary incontinence.


METHODS
From January 1992 to July 1997, 28 patients in a consecutive, prospective clinical case study were subjected to laparoscopic paravaginal repair. No concomitant surgery was performed. A clinical diagnosis of genuine stress urinary incontinence was documented by cystometry following a positive cough stress test. When indicated, a multichannel urodynamics study was performed.


RESULTS
In 16 patients (57%) of 28, the right pelvic side was affected, and in 43% fascia damage was identified and repaired bilaterally. The average operative time was 2 hours, 45 minutes; average blood loss was 1.2 g hemoglobin. No intraoperative, immediate postoperative, delayed postoperative or anesthesia-associated complications were observed. Patients were discharged from the surgical units in an average of 5 hours, 15 minutes. There was no postoperative hospital readmission.


CONCLUSIONS
Laparoscopic paravaginal repair is simple and safe and has a 93% cure rate. It is an attractive alternative to laparotomy.
Ostrzenski
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Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, D.C., USA. ostrzenski@msn.com
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*