Laparoscopic colposuspension using sutures or prolene meshes: a 3-year follow-up.
OBJECTIVE
To compare the long-term effectiveness of two different laparoscopic colposuspension procedures.


METHODS
Sixty women affected by genuine stress incontinence (GSI) were enrolled in a prospective randomized controlled trial (RCT) and treated by transperitoneal laparoscopic colposuspension using nonabsorbable sutures (group A) or prolene mesh fixed with tackers or staplers (group B). In each group the subjective and objective failure rates were evaluated at 12, 24, and 36 months after surgery. For the subjective evaluation patients were asked whether they had experienced urine leakage and any urine loss they reported was recorded on a visual analogue scale (VAS). The objective evaluation was performed by means of a clinical examination and multichannel urodynamic studies. The data were analyzed by the intention-to-treat method.


RESULTS
The subjective failure rate was significantly (P < 0.05) lower in group A than in group B at 12 months (3.3% versus 13.3%, respectively), 24 months (20.0% versus 36.7%, respectively), and 36 months (33.3% versus 53.3%, respectively) after surgery. The objective failure rate also differed significantly (P < 0.05) between the two groups after 12 (10.7% versus 25.0% for group A and group B, respectively), 24 (29.6% versus 57.7%, respectively), and 36 (42.3% versus 61.5%, respectively) months of follow-up.


CONCLUSIONS
Laparoscopic colposuspension performed with sutures is more effective than laparoscopic colposuspension accomplished with the use of prolene meshes in the long term, and the use of prolene meshes should be avoided in treatment of GSI.
Zullo
Fulvio
F
Department of Obstetrics and Gynecology, University Magna Graecia of Catanzaro, Via Nicolardi 188, I-80131 Naples, Italy.
Palomba
Stefano
S
Russo
Tiziana
T
Sbano
Francesco Maria
FM
Falbo
Angela
A
Morelli
Michele
M
Pellicano
Massimilano
M
Mastrantonio
Pasquale
P
D003127:Colposcopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011446:Prospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics