Chinese Medicine Body Constitution Research Articles

Associations of traditional Chinese medicine body constitution and all-cause mortality in patients with type 2 diabetes mellitus: a prospective cohort study of a Taiwanese medical center.

The objective of this study was to investigate associations between baseline body constitutions (BCs) in traditional Chinese Medicine (TCM) and all-cause mortality in Chinese individuals with type 2 diabetes. A total of 887 individuals with type 2 diabetes who were enrolled in managed care in 2010 were included. These individuals were followed up until 2015, and their mortality status was determined through the use of Taiwan National Death Datasets. At baseline, BC status of participants, including Yin deficiency, Yang deficiency, and phlegm stasis, was assessed using a well-developed Body Constitutions Questionnaire. Hazard ratios (HR) were calculated using a multivariate Cox proportional hazards model. During 6807.2 person-years of follow-up of 887 participants, with an average follow-up period of 7.7 years, a total of 190 individuals died, resulting in an incidence density of 0.0279 person-years. Yin deficiency was associated with all-cause mortality (HR, 95% CI: 1.39, 1.02-1.90). This study indicates that individuals diagnosed with Yin deficiency in TCM, characterized by symptoms such as thirst, reduced urine volume, hard stool, and hot flushes, had a 39% higher risk of all-cause mortality. The findings may provide information for TCM practitioners on tailoring treatment plans for persons with type 2 diabetes. No conclusive statements can be made on the basis of the preliminary data presented here. Controlled prospective studies are warranted.

Validation of the Cantonese version of the Traditional Chinese Medicine (TCM) Body constitution Questionnaire in elderly people

BackgroundThe Traditional Chinese Medicine (TCM) Body Constitution Questionnaire (For Elderly People) (TCMECQ) is a patient-reported outcome questionnaire developed in Mandarin in 2013 to differentiate the body constitutions of the elderly aged 65 and above. Considering the cultural and linguistic differences between Mainland China and Hong Kong (HK) Special Administrative Region, the TCMECQ was translated into Cantonese following “back translation” policy and validated in proper process.MethodsTen Chinese Medicine Practitioners (CMPs) and 30 senior citizens aged 65 or above were recruited to evaluate the first version of the Traditional Chinese Medicine Body Constitution Questionnaire (For Elderly People) (Cantonese version) (TCMECQ-C). Based on their comments, the second version was developed and discussed in the panel meeting to form the third version, validated the third version on 270 recruited seniors. Based on the validation results, a panel of 5 experts finalized the Questionnaire as the final version. The TCMECQ-C developers finalized the Questionnaire as the validated endorsed third version (i.e. final version).ResultsThe item-level content validity index of most items of the TCMECQ-C (First Version) were ranging from 0.80 to 1.00 in terms of clarity, relevance and appropriateness. Factor loadings of Qi-deficiency Constitution ranging from 0.37 to 0.71, Yang-deficiency Constitution ranging from 0.36 to 0.65, Yin-deficiency Constitution ranging from 0.36 to 0.65, and Stagnant Qi Constitution ranging from 0.68 to 0.82. The chi-squared degree-of-freedom ratio was 2.13 (928.63/436), Goodness-of-Fit Index (0.83), Adjusted Goodness-of-Fit Index (0.79), Normed Fit Index (0.66), Comparative Fit Index (0.78), Incremental Fit Index (0.78), Relative Fit Index (0.61) and Tucker–Lewis Index (0.75), and Root Mean Square Error of Approximation (0.07) and Standardized Root Mean Square Residual (0.07), implied acceptable Confirmatory Factor Analysis model fit of the overall scale. A Pearson correlation coefficient (r) showed the sufficient convergent validity for excessive subscales (Phlegm-dampness Constitution and Dampness-heat Constitution with r = 0.35, p < 0.01). Cronbach’s alpha coefficient ranged from 0.56 to 0.89, including Qi-deficiency Constitution (0.67), Yang-deficiency Constitution (0.84), Yin-deficiency Constitution (0.59), Stagnant Blood Constitution (0.56), Stagnant Qi Constitution (0.89), Inherited Special Constitution (0.76) and Balanced Constitution (0.73), indicating acceptable internal consistency for subscales. The intra-class correlation coefficients of the TCMECQ-C ranged from 0.70 to 0.87 (p < 0.001), indicating moderate to good test–retest reliability.ConclusionTCMECQ-C is a valid and reliable questionnaire for assessing the body constitution in Cantonese elderly.

Immigration studies of cardiovascular disease and international differences in traditional Chinese medicine body constitution

Immigration studies of cardiovascular disease and international differences in traditional Chinese medicine body constitution

Associations between traditional Chinese medicine body constitution and obesity risk among US adults

Associations between traditional Chinese medicine body constitution and obesity risk among US adults

Association between traditional Chinese medicine body constitution deviation and chronic pelvic pain: A cross-sectional study.

Chronic pelvic pain (CPP) is one of the most challenging conditions that physicians and patients face nowadays. This study aimed to assess the traditional Chinese medicine (TCM) body constitution profiles, demographic characteristics, and lifestyle of women suffering from CPP. This study included 378 female patients of reproductive potential from a single Obstetrics and Gynecology clinic in Taiwan. Data were collected using the Short Form 36 Health Survey Questionnaire (SF-36), the TCM Body Constitution Deviation (BCQ-44) Questionnaire, and the Behavior Rating Scale. The chi-squared test, the Kruskal-Wallis test, the Mann-Whitney U test, and Spearman's correlation were used to analyze the data. TCM body composition deviation was correlated with the level of pain in patients with CPP. Moreover, the quality of life (QOL) of these patients was found to be affected by the level of pain. Additionally, the QOL was correlated with the TCM body composition deviation profile. The TCM BCQ-44 can be used in the medical practice to assess patients' health status and can also serve as a guide to address the risk factors for CPP.

Validation of the English Version Constitution in Chinese Medicine Questionnaire (CCMQ) among Young Adults in Malaysia

Constitution in Chinese Medicine Questionnaire (CCMQ) is widely used as a self-administered health instrument. It was used as the guiding tool for prognosis, prevention and treatment of various diseases. This study aims to validate an English version of the Constitution in Chinese Medicine Questionnaire (CCMQ) in Malaysia, which is comprised of nine domains with a total of 67 questions. The survey was conducted in three phases. Phase one involved translation and adaption where the Chinese version of the survey instrument was translated into the English version. In phase two, a Delphi was used to review, amend and validate the translated English version; and in phase three, 114 subjects (aged 18 to 30 years old) were included in the confirmatory factor analysis to determine its psychometric properties. The construct validity analysis of CCMQ showed a good fit for the hypothesised models. Composite reliability (CR) values ranging from 0.869 to 0.908, and average variance extracted (AVE) values ranged from 0.647 to 0.764, indicating good internal consistency reliability and convergent validity, respectively. The heterotrait-monotrait ratio of correlations (HTMT) values obtained for all the domains ranging from 0.151 to 0.652, which fulfilled the criteria of discriminant validity. The English version of the CCMQ was the first statistically validated instrument in Malaysia. It is a reliable and valid instrument for traditional Chinese medicine body constitution (TCMBC) study. Future research is needed to validate the CCMQ as a predicting tool in health-related outcome studies.

Different distribution of traditional Chinese medicine body constitution across population, mechanism and implications

Different distribution of traditional Chinese medicine body constitution across population, mechanism and implications

Different traditional Chinese medicine body constitution in non-Hispanic White and Chinese patients with colorectal polyp

Different traditional Chinese medicine body constitution in non-Hispanic White and Chinese patients with colorectal polyp

Association of traditional Chinese medicine body constitution and cold syndrome with leukocyte mitochondrial functions: An observational study.

Body constitution in traditional Chinese medicine (TCM) refers to the holistic and relatively durable state of an individual, based on the qi and blood assessment, and TCM syndrome is defined as the theoretical abstraction of disease-symptom profiles. The biological basis as related to mitochondria, which produce most of the cellular energy, has not been well studied. This study aimed to elucidate the association of mitochondrial function with TCM body constitution and cold syndrome. Body constitution and cold syndrome in TCM were assessed using the Constitution in Chinese Medicine Questionnaire (CCMQ). The mitochondrial function of peripheral leukocytes was evaluated based on oxygen consumption rate (OCR) and enzyme activity; OCR reflects mitochondrial activity and the capacity to produce adenosine triphosphate (ATP). Cellular adenosine nucleotides and malondialdehyde levels were determined using high-performance liquid chromatography to assess the potential bioenergetic mechanisms. A total of 283 adults participated in this study. Leukocytes from subjects with a balanced constitution had higher OCRs than those with unbalanced constitutions. Yang deficiency and cold syndrome also demonstrated lower energy metabolism, as indicated by reduced basal metabolic rate and cellular levels of ATP and malondialdehyde. Decreased mitochondrial enzyme activity has been observed in individuals with the cold syndrome. Unbalanced body constitutions in TCM impair mitochondrial function in leukocytes, which may contribute to the high disease susceptibility. Cold syndrome is characterized by reduced mitochondrial mass, which may explain its symptoms of low-energy metabolism and cold intolerance.

The Analysis of Chinese Medicine Body Constitutions of Polycystic Ovarian Syndrome Patients in Malaysia

The Analysis of Chinese Medicine Body Constitutions of Polycystic Ovarian Syndrome Patients in Malaysia

Traditional Chinese medicine body constitution predicts new-onset diabetic albuminuria in patients with type 2 diabetes: Taichung diabetic body constitution prospective cohort study

This prospective cohort study explored whether body constitution (BC) independently predicts new-onset albuminuria in persons with type 2 diabetes mellitus (T2DM) enrolled in the diabetes care management program (DCMP) of a medical center, providing evidence of integrating traditional Chinese medicine into DCMP for improving care quality. Persons with T2DM (n = 426) originally without albuminuria enrolled in DCMP were recruited in 2010 and were then followed up to 2015 for detecting new-onset albuminuria. The participants received urinalysis and blood test annually. Albuminuria was determined by an elevated urinary albumin/creatinine ratio (≥ 30 µg/mg), and poor glucose control was defined as Glycosylated hemoglobin above or equal to 7%. BC type (Yin deficiency, Yang deficiency, and phlegm stasis) was assessed using a well-validated body constitution questionnaire at baseline. Risk factors for albuminuria (sociodemographic factors, diabetes history, lifestyle behaviors, lipid profile, blood pressure, and kidney function) were also recorded. Hazard ratios (HR) of albuminuria for BC were estimated using multivariate Cox proportional hazards model. During the 4-year follow-up period, albuminuria occurred in 30.5% of participants (n = 130). The HR indicated that Yin deficiency was significantly associated with an increased risk of new-onset albuminuria in persons with T2DM and good glucose control after adjustment for other risk factors (HR = 2.09; 95% confidence interval = 1.05-4.17, P = .04), but not in those with poor glucose control. In persons with T2DM and poor glucose control, phlegm stasis was also significantly associated with a higher risk of albuminuria (2.26; 1.03-4.94, P = .04) after multivariate adjustment, but not in those with good glucose control. In addition to already-known risk factors, BC is an independent and significant factor associated with new-onset albuminuria in persons with T2DM. Our results imply Yin deficiency and phlegm stasis interacting with glucose control status may affect new-onset albuminuria in persons with T2DM.

Traditional Chinese Medicine Body Constitutions as Predictors for Depression: A Systematic Review and Meta-Analysis.

Traditional Chinese medicine body constitution (TCMBC) reflects a person's vulnerability to diseases. Thus, identifying body constitutions prone to depression can help prevent and treat depression. The review aimed to assess and summarize the existing evidence that explores the relationship between TCMBC and depression. Psychology and Behavioral Sciences Collection, MEDLINE, PubMed, CNKI, Wanfang, SinoMed, Embase, VIP, CINAHL, and CMJ were searched from inception to April 2021. Observational studies assessing the association between TCMBC and depression were selected. The quality of the included studies were assessed using the Newcastle-Ottawa Scale (NOS). Eighteen studies were included in the systematic review and thirteen in the meta-analysis. The pooled odd ratios of developing depression for Qi-stagnation, Qi-deficiency, Yang-deficiency, Yin-deficiency, and Balanced constitutions were 3.12 (95% CI, 1.80-5.40; I2 = 94%), 2.15 (95% CI, 1.54-3.01; I2 = 89%), 1.89 (95% CI, 0.71-5.03; I2 = 81%), 1.41 (95% CI, 0.91-2.20; I2 = 57%), and 0.60 (95% CI, 0.40-0.90; I2 = 94%), respectively. The findings suggest that the evaluation of a person's TCMBC could be useful the in prevention and treatment of depression. However, more case-control and cohort studies are required to further confirm the association between TCMBC and depression.

Effects of Chinese medicine for COVID-19 rehabilitation: a multicenter observational study

ObjectivesThis study aimed to evaluate the effects of Chinese Medicine (CM) on the health condition of the post-COVID-19 patients, particularly with the CM Syndrome diagnosis and Body Constitutions (BC), as well as related clinical characteristics.Methods150 participants who had COVID-19 and discharged from Hong Kong public hospitals were recruited. They were provided with three to six months of CM treatments, during which assessments were made per month and at follow-up on their CM syndromes, BC, lung functions, and other medical conditions. This study was divided into two parts: (1) Retrospective survey: medical history of participants during COVID-19 hospitalization was collected during the baseline visit; (2) Prospective observation and assessments: clinical symptoms, lung functions, and BC status were evaluated in participants receiving CM treatment based on syndrome differentiation and clinical symptoms.ResultsThe median hospitalization period was 16 days. Symptoms were presented in 145 (96.6%) patients at the day they were diagnosed with COVID-19. Fever, fatigue, and dry cough were the most common symptoms, exhibiting in 59.3% (89 of 150), 55.3% (83 of 150), and 46% (70 of 150) participants, respectively. Among the 150 post-COVID patients, majority (71.3%) were of the two particular post-COVID CM Syndromes (Qi Deficiency of Lung and Spleen, and Qi and Yin Deficiency). Upon CM treatment, there was an observable increase in participants reaching a balanced BC (i.e. healthy body conditions). The increase was observed to be more prominent in those without the particular CM Syndromes compared to those with the CM Syndromes. Main clinical symptoms in participants with the CM Syndromes decreased upon CM treatment. Occurrence of fatigue also dropped after CM treatment though not all accompanied clinical symptoms were resolved fully. Further to the improvement in terms of CM assessments, lung functions of the participants were found to show improvement after treatment. Both the performance in 6MWT and scores in the LFQ improved upon CM treatments (P < 0.05).ConclusionThis study provided evidence for individualized CM treatment on COVID-19 rehabilitation concerning the clinical symptoms improvements, lung functions improvement, and achieving a balanced BC. It is believed that CM may be a key to further promote rehabilitation and resolution of residual symptoms. Long-term large scale follow-up studies on sub-categorising post-COVID patients according to different CM syndromes would be required to further elucidate treatment of persistent symptoms that may be associated with long-COVID.

The Relationship between the Second-Generation Antipsychotics Efficacy and the Traditional Chinese Medicine Body Constitutions in Patients with Schizophrenia.

Background: Schizophrenia requires lifelong treatment; Second-generation Antipsychotics (SGAs) have become the most prescribed medication for schizophrenia patients. The efficacy of various SGAs treatment may differ in schizophrenia patients with various traditional Chinese medicine (TCM) body constitution (BC) types. Method: This study applied a longitudinal quantitative research design, where a total of 66 participants were recruited. The Positive and Negative Symptom Scale (PANSS) and the Clinical Global Impression (CGI) score were used to evaluate patients’ psychopathology status in hospitalization, and body constitution questionnaires were conducted by face-to-face interviews in the 1st, 3rd, and 6th week of hospitalization. Results: More than 60% of schizophrenia patients who were treated with SGAs were classified to have unbalanced BC types including Yin-Xu, Yang-Xu and Stasis. Generalized estimating equation analysis revealed significant time effects in CGI and PANSS score improvements in both unbalanced and gentleness (balance) BC types, but no significant changes in the group and group-time interaction in the CGI and PANSS scores in different BC type groups. Conclusions: Schizophrenia patients under SGAs treatment had a higher proportion of unbalanced BC types which may lead to poorer physical or mental statuses, such as overweight problems. Health care providers could apply interventions according to patients’ BC types for disease prevention.

Association of Traditional Chinese Medicine Body Constitution and Health-Related Quality of Life in Female Patients with Systemic Lupus Erythematosus: A Cross-Sectional Study.

Background Traditional Chinese medicine (TCM) body constitution has been studied in many diseases, but few have focused on systemic lupus erythematosus (SLE) and particularly their association with disease-specific quality of life (QoL). Therefore, the aim of this study was to investigate the association of TCM body constitution and QoL in female patients with SLE. Methods A cross-sectional study was conducted on adult female patients with a clinician-confirmed diagnosis of SLE in a regional hospital in Taiwan. TCM body constitution types were determined using the Constitution in Chinese Medicine Questionnaire (CCMQ). Disease-specific QoL of the participants was assessed using the LupusQoL. Multiple linear regression analyses were conducted to assess the associations between TCM body constitution types with the score of each of the eight domains of LupusQoL and between the numbers of multiple unbalanced body constitution types and score of each of the eight domains of LupusQoL. Results Of the 317 female patients with SLE, 22 (6.9%) were classified to have a gentleness balanced body constitution type. Among the remaining 295 patients with unbalanced body constitution types, Qi-deficiency was the most common (64.4%), followed by Yin-deficiency (57.6%). Multiple linear regression analyses showed that Qi-deficiency was significantly associated with the emotional, pain, and fatigue domains of the LupusQoL, whereas Yin-deficiency was significantly associated with the emotional and fatigue domains of the LupusQoL. In addition, all domains of the LupusQoL showed a general pattern of poorer QoL with increasing numbers of unbalanced body constitution types. Conclusions Different TCM body constitution types were significantly associated with various domains of the LupusQoL. A high prevalence of multiple body constitution types in patients with SLE was observed. A consistent pattern of poorer LupusQoL with increasing numbers of unbalanced body constitution types was evident.

The Association Between Traditional Chinese Medicine Body Constitution Deviation and Essential Hypertension: A Case-Control Study.

The prevention and treatment of hypertension is valued globally. The World Health Organization advocates combining traditional medicines in the prevention and treatment of diseases. Traditional Chinese medicine (TCM) assumes that diseases originate from the attenuation of one's body constitution. A few studies have found that hypertension is correlated with TCM body constitution. However, body constitution is also affected by living environment. Therefore, investigating the correlation between deviations in body constitution and essential hypertension in different living environments is necessary to provide the basis for using TCM in combination with conventional Western medicine to prevent and treat hypertension. The aim of this study was to explore the association between TCM body constitution deviation and essential hypertension. A case-control study was designed. Participants were selected from the outpatient clinics and neighboring communities of a regional teaching hospital in southern Taiwan. The study included 210 hypertension and 210 nonhypertension cases. Blood pressures were measured using an electronic sphygmomanometer to confirm the presence or absence of hypertension. The TCM Body Constitution Questionnaire, demographic datasheet, and hypertension-related factors questionnaire were used to collect data. A higher proportion of patients with body constitution deviation were found in the hypertension group than the nonhypertension group. The proportions of patients with Yin-Xu, Yang-Xu, and stasis constitution were 44.8%, 32.4%, and 30.6%, respectively, in the hypertension group and 28.6%, 25.2%, and 19.6%, respectively, in the nonhypertension group. After performing univariate analysis, the results showed significant differences between the two groups in terms of average body mass index; emotional traits of anger, worry, and fear; hyperlipidemia; hyperuricemia; Yin-Xu constitution; and stasis constitution. However, the multivariate analysis revealed having a Yin-Xu constitution to be a risk factor of essential hypertension after adjusting for age, gender, body mass index, emotional traits, drinking habit, hyperlipidemia, and hyperuricemia. The results suggest that Yin-Xu and stasis constitutions are respectively associated with essential hypertension. The findings offer a valuable reference to governments and healthcare professionals to prevent the risk of essential hypertension. Screening and healthcare measures for TCM Yin-Xu or stasis constitution may be included in related prevention plans to minimize public exposure to the risk factors of essential hypertension.

Traditional Chinese Medicine Body Constitutions and Psychological Determinants of Depression among University Students in Malaysia: A Pilot Study.

Depression is commonly observed in university students, who are a high risk group for developing psychiatric disorders during adulthood. This study aimed to determine the prevalence of depression and its traditional Chinese medicine body constitutions and psychological determinants among university students in Malaysia. A cross-sectional pilot study was conducted between 9 and 28 September 2020 among 80 university students in Malaysia. Participants completed online survey questionnaires, including the validated Patient Health Questionnaire (PHQ-9), Constitution in Chinese Medicine Questionnaire (CMCQ), Dysfunctional Attitude Scale (DAS), Depression Anxiety Stress Scale (DASS-21) stress subscale, Perceived Stress Scale (PSS-10), and Rosenberg Self-Esteem Scale (RSES), which assess depression, body constitution, dysfunctional attitude, stress, perceived stress, and self-esteem. Multiple linear regression analyses were performed to determine the associated risk factors for depression. The overall prevalence of depression among university students was 33.8%. The multiple regression analysis showed a significant relationship between depression and qi-stagnation constitution (B = 0.089, p = 0.011), balanced constitution (B = −0.077, p = 0.049), and self-esteem (B = −0.325, p = 0.001). Our findings suggest that some traditional Chinese medicine body constitutions and self-esteem are significant risk factors affecting depression among university students. Identifying risk factors of depression is vital to aid in the early detection of depression among university students.

The Relationships between Leptin, Genotype, and Chinese Medicine Body Constitution for Obesity

Methods The adults with body mass index (BMI) more than 27 kg/m2 were enrolled in the study. General personal information, physical condition, TCMBC, biochemical, and SNPs were collected for eligible subjects. The body constitution questionnaire (BCQ) was used to evaluate the relationships between TCMBC tendency, biochemical values, and obesity-related SNPs. Results Obesity patients tended to have a yin deficiency constitution (YinDC) (n = 33, 66.0%); however, TCMBC in combination is not uncommon (30 subjects with more than two TCMBC in combination). For biochemical profiles, leptin was higher among patients with yang deficiency constitution (YangDC) (YangDC versus non-YangDC: 29.7 ± 24.8 versus 15.9 ± 9.9, P=0.020) and YinDC (YinDC versus non-YinDC: 28.8 ± 23.5 versus 14.4 ± 9.6, P=0.020). The leptin level was highest among YangDC subjects. Higher leptin was found among subjects with three-combined TCMBC than balanced TCMBC subjects who were not inclined to any of three TCMBC. For obesity-related SNPs, the adrenergic receptor beta-3 (ADRB3) gene tended to be high expression among YangDC (YangDC versus non-YangDC: 89.7% versus 71.4%, P=0.091) and uncoupling protein 1 (UCP1) tended to be high expression among phlegm-stasis constitution (PSC) (PSC versus non-PSC: 37.9% versus 9.5%, P=0.052). Conclusions The relationships between TCMBC, leptin, and SNPs present alternative viewpoints about TCMBC and could be used as a guide to treat obese patients.

Association between cancer-related fatigue and traditional Chinese medicine body constitution in female patients with breast cancer

BackgroundCancer-related fatigue (CRF) is a common psychosomatic problem in breast cancer patients. Traditional Chinese medicine (TCM) has been used to address symptoms in patients with CRF. Identification of the specific constitution in TCM is essential for personalized care. AimTo explore the relationship between fatigue and specific constitutions in breast cancer. Experimental procedureWe conducted a cross-sectional study in all breast cancer patients at Kaohsiung Chang Gung Memorial Hospital in Taiwan. The severity of fatigue was determined using the Brief Fatigue Inventory-Taiwanese (BFI-T) form. TCM patterns were determined using the Body Constitution Questionnaire (BCQ). The relationship between constitution and fatigue was analyzed using logistic regression. ResultsWe recruited 110 breast cancer patients with fatigue (mean age: 55 ± 11 years). The mean duration of breast cancer was 17.4 months. The major constitution among these patients with fatigue was Yang-Qi deficiency (50%). Phlegm-Stasis syndrome was correlated with a duration of breast cancer of more than 18 months (p = 0.02). Out of all participants, 42.7% (n = 47) reported clinically significant fatigue (BFI-T score ≥4). According to logistic regression, the score of Yang-Qi deficiency [odds ratio (OR): 3.5, 95% confidence interval (CI): 1.49–8.21, p < 0.01] was also associated with clinically significant fatigue. ConclusionYang-Qi deficiency is associated with clinically significant fatigue in breast cancer patients. However, the association of Phlegm-Stasis syndrome and fatigue as disease duration increases cannot be ignored. Further studies are needed to determine whether treating both constitutions integrating TCM treatment can alleviate patients’ fatigue symptoms.

Chinese Medicine body constitution of community-dwelling stroke patients in Hong Kong

The artificial urinary sphincter (AUS) is not used extensively in the treatment of female urinary stress incontinence (USI) due to the poor reproducibility of the techniques used. We describe a new approach to laparascopic implantation, of which dissection of the vesicovaginal space is an essential step. This enables an approach under direct vision to the posterior surface of the bladder neck.We present two cases where this approach was used. A transperitoneal approach was made in the Trendelenburg position. The main steps were: creating the vesicovaginal space until identifying the bladder neck, creating two laterovesical spaces, communicating these with the vesicovaginal space, and dissecting the anterior surface of the bladder neck, attempting to preserve the pubovesical ligament. The cuff and reservoir were inserted through the 12 mm infraumbilical trocar. The connections were externalized through a left suprapubic incision and a subcutaneous tunnel created up to the labia majora where the activation pump was placed. The procedure was completed with closure of the peritoneum. It is essential to use a vaginal valve to facilitate dissection.Surgery time: 140 and 135 min, with no intraoperative complications. After removing the urinary catheter, one patient had elevated postvoid residual urine volume, which was managed conservatively. Hospital stay: 72 h. At 3 and 9 months the patients were fully continent.We present the preliminary results of laparoscopic implantation of an AUS through a vesicovaginal approach to the posterior surface of the bladder neck, which might reduce potential complications that have been observed after the routine techniques.El esfínter urinario artificial (EUA) no está extendido en el tratamiento de la incontinencia urinaria de esfuerzo (IUE) femenina debido a la baja reproducibilidad de las técnicas empleadas. Describimos un nuevo abordaje de implante laparoscópico, cuyo paso fundamental consiste en disecar el espacio vesicovaginal. Esto permite una aproximación bajo visión directa a la cara posterior del cuello vesical.Presentamos dos casos realizados con esta aproximación. Se realiza un abordaje transperitoneal en posición de Trendelenburg. Los principales pasos son: creación del espacio vesicovaginal hasta identificar el cuello, creación de dos espacios laterovesicales, comunicación de los mismos con el espacio vesicovaginal y disección de la cara anterior del cuello intentando preservar el ligamento pubovesical. El manguito y reservorio se introducen a través del trocar infraumbilical de 12 mm. Por una incisión suprapúbica izquierda se externalizan las conexiones y se crea un túnel subcutáneo hasta el labio mayor, donde se coloca la bomba de activación. Finaliza el procedimiento con el cierre del peritoneo. Es fundamental la utilización de una valva vaginal para facilitar la disección.Tiempo quirúrgico: 140 y 135 min, sin complicaciones intraoperatorias. Tras la retirada de la sonda vesical una paciente presentó residuo posmiccional elevado que se manejó de forma conservadora. Estancia hospitalaria: 72 h. A los 3 y 9 meses, las pacientes presentaron continencia total.Presentamos resultados preliminares de implante laparoscópico de EUA mediante la aproximación vesicovaginal a la cara posterior del cuello, que podría disminuir las potenciales complicaciones observadas con las técnicas habituales.