Laparoscopic two-team slings for women with stress urinary incontinence.
OBJECTIVE
To review long-term success and complication rates of laparoscopic two-team sling procedures in women with stress urinary incontinence or mixed incontinence confirmed by urodynamic testing and cystoscopy.


METHODS
Prospective study (Canadian Task Force classification II-2).


METHODS
Tertiary urogynecology unit at a university-affiliated teaching hospital.


METHODS
One hundred seventy-five women.


METHODS
Laparoscopic two-team sling procedure.


RESULTS
The extraperitoneal approach to the space of Retzius was accomplished using a balloon device, and the intraperitoneal approach involved a transverse incision through the anterior parietal peritoneum 6 cm above the symphysis. A 1.5- to 2.0-cm wide strip of polypropylene mesh was inserted through a vertical incision along the anterior vaginal wall, perforating the urogenital diaphragm under laparoscopic guidance. The mesh was sutured to Cooper's ligaments bilaterally with 0 polypropylene sutures. Mean operating time was 80.1 +/- 30.0 minutes, mean estimated blood loss was 160 +/- 146 ml, and mean hospital stay was 2.4 +/- 1.2 days. Patients were followed at 6 weeks, 6 months, 1 year, and yearly (mean 17.8 mo, range 1-5 yrs).


CONCLUSIONS
Laparoscopic two-team sling procedures can be performed safely in women with recurrent stress incontinence and those with risk factors for failure of retropubic urethropexy. Long-term success rates are excellent (91.1%) with few complications.
Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Rose C
RC
Kung
Grace
G
Liu
Patricia E
PE
Lee
Kay I
KI
Lie
John E
JE
Morgan
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011126:Polypropylenes; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*
D011126:Polypropylenes