Colpocystourethropexy: the way we do it

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Surgery

Background:

• Stress urinary incontinence (SUI) involves intrinsic sphincteric deficiency.
• Restoring proper anatomical support can re-establish normal urethral function.
• Previous surgical interventions may have limitations.

Purpose of the Study:

• To describe a suprapublic surgical approach for SUI repair.
• To evaluate the efficacy of a technique that avoids urethral compression.
• To achieve long-lasting repair through natural tissue healing.

Main Methods:

• Utilizing a suprapublic approach for anterior vaginal wall and vesicourethral segment mobilization.
• Placing full-thickness sutures from the anterior vaginal wall to Cooper's ligament.
• Clearing retropubic fat to promote postoperative fibrosis for permanent fixation.

Main Results:

• The technique successfully restores the vesicourethral segment to a normal position with limited mobility.
• Compression or obstruction of the urethra and damage to sphincteric muscles are avoided.
• Uniform success rates were observed in virginal cases and most challenging cases with prior failures.

Conclusions:

• Adequate mobilization, precise suture placement, and prevention of urethral compression are crucial for successful SUI repair.
• This suprapublic technique offers a reliable solution for stress urinary incontinence.
• Postoperative fibrosis plays a key role in achieving durable surgical outcomes.