Genuine stress urinary incontinence in women. New laparoscopic paravaginal reconstruction

To assess a new laparoscopic technique of paravaginal repair, adapted from a classic laparotomy procedure, for genuine stress urinary incontinence.

From January 1992 to July 1997, 28 patients in a consecutive, prospective clinical case study were subjected to laparoscopic paravaginal repair. No concomitant surgery was performed. A clinical diagnosis of genuine stress urinary incontinence was documented by cystometry following a positive cough stress test. When indicated, a multichannel urodynamics study was performed.

In 16 patients (57%) of 28, the right pelvic side was affected, and in 43% fascia damage was identified and repaired bilaterally. The average operative time was 2 hours, 45 minutes; average blood loss was 1.2 g hemoglobin. No intraoperative, immediate postoperative, delayed postoperative or anesthesia-associated complications were observed. Patients were discharged from the surgical units in an average of 5 hours, 15 minutes. There was no postoperative hospital readmission.

Laparoscopic paravaginal repair is simple and safe and has a 93% cure rate. It is an attractive alternative to laparotomy.