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[Preperitoneal laparoscopic retropubic colposuspension in the treatment of stress incontinence: the mesh and tacker technique].

UNLABELLED
The Burch procedure has enjoyed in the last decade a favourable status among open surgical repairs for stress urinary incontinence. In the last few years this technique was adapted for endoscopic application. This results in decreased recovery time and diminished postoperative patients discomfort. This endoscopic procedure was further simplified by means of extraperitoneal approach and through the use of Mesh & Tacker technique. This enables a high quality durable colposuspension in significantly shortened operational time.


OBJECTIVE
Evaluation of preliminary results and experiences of the above-mentioned new laparoscopic extraperitoneal approach in the treatment of stress incontinence.


SETTING
Department of Gynaecology and minimally invasive surgery Na Homolce Hospital.


DESIGN
Prospective pilot study.


METHODS
The patients with stress incontinence proven clinically and by means of urodynamic investigation (cystometry, stress profilometry and uroflowmetry) were included in the study. The Retzius space was dissected laparoscopically via preperitoneal distention balloon (PDB, Origin Medsystems). Colpofixation to Coopers ligaments was achieved by means of Mesh & Tacker technique, e.g. polypropylen Mesh and aplicator of helicose spirals (Origin Medsystems).


RESULTS
In this pilot study of initial 8 patients we may conclude that the above-mentioned method is promising. Of note is shortened operational time (35 min), easy performance without necessity of laparoscopic endosuturing and minimal tissue damage. The small amount of patients and short follow up period would not allow definite conclusions but all the patients are sofar fully continent.