Laparoscopic colposuspension: a short term urodynamic follow-up and a three-year questionnaire-study.
BACKGROUND
The purpose of the study was to evaluate outcome, urodynamic correlates and adverse effects of laparoscopic colposuspension using polytetrafluoroethylene sutures.


METHODS
Eighty-five consecutive women with primary stress urinary incontinence at one university hospital were included in this prospective non-controlled study. During videolaparoscopic surgery, two polytetrafluoroethylene sutures were placed on each side of the urethra and fixed to the Cooper ligaments. Pre- and postoperative clinical and urodynamic evaluations, including pad-test, were performed. A mailed questionnaire was used to evaluate cure-rate and complication-rate three years after surgery.


RESULTS
At follow-up examination, we considered 62 of 76 women (82%) as being cured, ten (13%) improved, and four (5%) as being failures. The questionnaires were returned by 80 women; 41 (51%) considering themselves as cured and 31 (39%) improved, and eight women (10%) as unimproved or minimally improved. Clinical outcome was not associated with alterations in urethral functional length or in urethral closing pressure. Short preoperative urethral functional length was associated with failure (p=0.04).The incidence of new onset urge symptoms and of new onset recto/enterocele was 13% and 9% respectively.


CONCLUSIONS
Laparoscopic colposuspension resulted in acceptable cure rate in short-, and medium long term evaluation. However, a decline in cure rate was observed. Cured women had significantly longer preoperative urethral functional length than women still leaking after surgery.
Persson
J
J
Department of Obstetrics and Gynecology, Lund University Hospital, Sweden.
Bossmar
T
T
Wølner-Hanssen
P
P
D000328:Adult; D003127:Colposcopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013537:Sutures; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology*
D011138:Polytetrafluoroethylene