Laparoscopic-assisted transpectineal needle suspension of the bladder neck

Abstract

We performed laparoscopic-assisted colposuspension combining features of Burch retropubic and transvaginal needle colposuspension for the treatment of genuine stress incontinence in 10 women. No patient had previously undergone incontinence surgery. Mean operating time was 27 minutes (range 21–40 min). Mean postoperative hospital stay was 36 hours (range 24–72 hrs). The surgeries were uncomplicated. One patient experienced transient urinary retention. At a mean follow-up interval of 20 months (range 12–35 mo), all women remain free of stress urinary incontinence. The speed and simplicity of Pereyra-type suture placement are retained without recourse to endoscopic suturing, and laparoscopic assistance permits the development of the space of Retzius and incorporation of Cooper's ligament in the path of suspending sutures under direct vision. Our preliminary experience suggests that this procedure may be an effective alternative to transvaginal needle suspension and open or laparoscopic retropubic colposuspension.