[Feasibility of the laparoscopic sub-urethral sling procedure].
OBJECTIVE
To evaluate the feasibility of the laparoscopic sling procedure, 44 patients 26 to 66 years old (average 45) with sphincter incompetence were included in this prospective series between 1993 and 1999.


METHODS
Patient selection for a sling procedure was based on urodynamic findings (average closure pressure was 34 cm of water). The operative procedure is described.


RESULTS
The follow up ranged from two to 66 months (average 27.6). Seven conversions into laparotomy had to be performed. 35 slings could be set successfully. Four of these slings had to be removed during the year following the procedure; two because of bladder neck erosion and two because of chronic bladder distension. The success rate of the 35 slings is 88.6%. The overall complication rate is 27% including five bladder injuries, 2 urether injuries and one hemorrhage. Ten of the twelve complications occurred in the 12 first patients and the complication rate decreased to 9% in the 32 last patients. Average hospital stay was 4 days.


CONCLUSIONS
The laparoscopic sling procedure seems to be promising in the management of refractory urinary incontinence due to sphincter incompetence. But it is an advanced laparoscopic procedure for experienced laparoscopic surgeons, needing a long learning curve.
von Theobald
P
P
Service de Gynécologie-Obstétrique, CHU de Caen.
Lucas
J
J
Barjot
P
P
Cheret
A
A
Grosdemouge
I
I
Herlicoviez
M
M
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014549:Urinary Incontinence / Q000601:surgery*
Faisabilité de la fronde sous-urétrale coelioscopique.