Treatment of Stress Urinary Incontinence with Laparoscopic Bladder Neck Suspension using Extracorporeal Needle Compared with Laparoscopic Bladder Neck Suspension and Raz`s Operations

Lee, Jong Jin; Lee, Tchun Yong

Abstract

PURPOSE: Laparoscopic bladder neck suspension is an effective treatment for genuine stress urinary incontinence. To decrease the operating time, associated morbidity and hospital stay, we introduced laparoscopic bladder neck suspension using extracorporeal needle. We assessed the feasibility of this new technique, and compared with simple laparoscopic bladder neck suspension and transvaginal Raz procedure.
MATERIALS AND METHODS
Eleven patients underwent a laparoscopic bladder neck suspension using extracorporeal needle were compared with 16 patients underwent simple laparoscopic bladder neck suspension and 66 patients treated with transvaginal Raz procedure for genuine stress urinary incontinence. All patients were assessed for their age, duration of symptom, operative time, length of hospital stay, postoperative residual urine volume, complications, and success rate.
RESULTS
The result of present method was cure in 82% and improvement in 18% of patients. The overall success rate of three methods were similar. Average duration of postoperative admission was 3.4 days and average residual urine volume at discharge was 12.1 ml (simple laparoscopic Burch procedure: 5.1 days and 22.1 ml; Raz procedure: 7.7 days and 37.5 ml). Operative time of laparoscopic bladder neck suspension using extracorporeal needle was shorter than the simple laparoscopic bladder neck suspension and transvaginal Raz procedure (55 vs. 125 and 102 minutes).
CONCLUSION
Laparoscopic bladder neck suspension using extracorporeal needle is a good technique for treatment of genuine stress urinary incontinence. However, additional long term follow-up study will be required.