Laparoscopic management of incontinence and pelvic organ prolapse

Laparoscopy provides an enticing alternative for incontinence and pelvic floor procedures that would otherwise require a laparotomy or that would be difficult vaginally. Despite some data suggesting lower cure rates with the laparoscopic Burch when compared with the open approach or trans-vaginal tape, the safety and relative efficacy of the laparoscopic procedure support its continued use. Laparoscopic sacrocolpopexy seems to yield comparable outcomes when compared with the open approach and is associated with a shorter hospitalization. Although laparoscopic paravaginal defect, cystocele, and rectocele repairs are technically feasible and may have a role as a concomitant procedure, a vaginal approach is more appropriate for an isolated operation.