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Laparoscopic colposuspension: a systematic review.

Birgit Moehrer1, Marcus Carey, Don Wilson

  • 1Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

BJOG : an International Journal of Obstetrics and Gynaecology
|March 12, 2003
PubMed
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Laparoscopic colposuspension shows similar subjective cure rates for stress urinary incontinence compared to open surgery. However, open surgery may offer a slightly better objective cure rate, though evidence is limited.

Area of Science:

  • Urology
  • Gynecology
  • Minimally Invasive Surgery

Background:

  • Stress urinary incontinence (SUI) significantly impacts women's quality of life.
  • Colposuspension is a surgical option for SUI treatment.
  • Laparoscopic approaches aim to reduce surgical morbidity.

Purpose of the Study:

  • To evaluate the effectiveness of laparoscopic colposuspension versus open colposuspension for SUI treatment.
  • To compare subjective and objective cure rates, quality of life, and surgical outcomes.

Main Methods:

  • Systematic review of randomized and quasi-randomized trials.
  • Included trials compared laparoscopic surgery with open surgery for SUI.
  • Outcomes assessed included subjective and objective cure, quality of life, and complications.

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Main Results:

  • Eight trials were included. Five compared laparoscopic (233 women) and open (254 women) colposuspension.
  • Open colposuspension showed a significantly lower risk of a positive stress test (objective failure).
  • Subjective cure rates were similar; laparoscopic surgery trended towards fewer complications, less pain, shorter hospital stay, and faster return to normal function.

Conclusions:

  • Limited evidence due to short follow-up and small trial numbers.
  • No significant difference in objective or subjective cure between laparoscopic and open colposuspension may exist.
  • Further well-designed, adequately powered randomized controlled trials are needed.