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Extraperitoneal retropubic laparoscopic urethropexy
S L Hannah1, B Roland, P M Gengenbacher
1Department of Obstetrics and Gynecology, Swedish Medical Center, Englewood, Colorado, USA.
Study Objective:
To report long-term follow-up of 300 patients undergoing extraperitoneal retropubic bladder suspension using balloon distention and mesh suspension.
Design:
Observational study (Canadian Task Force classification II-2).
Setting:
Private practice.
Patients:
Three hundred women with urinary incontinence.
Intervention:
Extraperitoneal retropubic bladder neck suspension with mesh, after balloon distention of the space of Retzius performed under general anesthesia in 162 (54%) and epidural anesthesia in 138 (46%).
Measurements And Main Results:
Eight procedures were converted to open urethropexy, resulting in 259 laparoscopic urethropexies. Spontaneous voiding resumed within 24 hours in 235 patients (90.4%). Follow-up was available for 267 patients and ranged from 1.5 to 5.5 years (mean 3.28 yrs). Of these, 173 women (67%) reported that they were cured and 64 (24.5%) were satisfied with the result; 22 (8.5%) were considered failures.
Conclusion:
Extraperitoneal retropubic bladder neck suspension with mesh results in a durable repair and is associated with relatively short operating time, low morbidity, and excellent patient satisfaction. (J Am Assoc Gynecol Laparosc 8(1):107-110, 2001)