Laparoscopic colposuspension using mesh reinforcement

Birken, R. A.; Leggett, P. L.

doi:10.1007/s004649900542

Cited by 15 publications

(6 citation statements)

References 16 publications

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“…Modified laparoscopic techniques fixing strips of hernia mesh to the paraurethral tissue and Cooper's ligament using surgical staples or a tacking device were described to replace endoscopic suture suspension [8–10]. These new developments were proposed to reduce the technical complexity of laparoscopic colposuspension while still maintaining a high success rate [10–13].…”

Section: Introductionmentioning

confidence: 99%

The efficacy of laparoscopic mesh colposuspension: results of a prospective controlled study

El-Toukhy

Davies

2001

BJU International

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Objective To investigate the ef®cacy of laparoscopic mesh colposuspension as an equivalent approach to the`gold standard' open Burch colposuspension. Patients and methods A prospective controlled study of laparoscopic mesh colposuspension was conducted over 2 years; 87 patients with genuine stress incontinence (GSI) were recruited. The preoperative evaluation included a history, examination, midstream urine analysis, urinary voiding diary, a Urilos pad test, and twin-channel subtracted cystometry, including urethral pro®lometry and measurement of the postvoid residual volume. The study included patients who had undergone previous incontinence surgery, but those with detrusor instability or neurogenic bladder were excluded. The patients were assessed at 6 weeks, 6 months and 1 year after surgery and then yearly thereafter. The urodynamic assessment was repeated 3 months after surgery. Results Forty-nine patients underwent laparoscopic colposuspension using Prolene mesh and titanium tacks to elevate the bladder neck, while 38 patients had open Burch colposuspension. There was no difference between the groups in age, parity, body mass index, menopausal status, medical history, previous bladder neck surgery and prolapse. At 6 weeks the cure rate was similarly high in the two groups (91% laparoscopic and 94% open). After a mean follow-up of 32 months, both groups showed a decline in ef®cacy, which was more marked in the laparoscopic group. Cure rates were 62% for laparoscopy and 79% for open surgery, and the improvement rates were 77% and 89%, respectively (P<0.05). Conclusion Laparoscopic colposuspension using a mesh and tacker technique reduces the technical dif®culty and operating time of the endoscopic procedure, but the long-term cure rates are inferior to open Burch colposuspension.

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Section: Introductionmentioning

confidence: 99%

The efficacy of laparoscopic mesh colposuspension: results of a prospective controlled study

El-Toukhy

Davies

2001

BJU International

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“…It was initially unclear whether 2 sutures were better than mesh and staples techniques. 12,13,19,26 Early results showed that the mesh seemed to be as effective as suture 18 ; however, recent data suggest laparoscopic suture is better than prolene mesh, 15 because of a significantly lower objective cure rate in the LSC mesh group at 36 months compared with the suture group (39% vs. 57%, P Ͻ 0.05).…”

Section: Discussionmentioning

confidence: 79%

“…[12][13][14][15][16][17][18] The surgical technique in the current study involved placing 2 sets of permanent supportive sutures bilaterally (Gore-tex THX-26; catalog no. 2N05; suture length 36 in) for both the intraperitoneal laparoscopic and open Burch approach.…”

mentioning

confidence: 99%

Laparoscopic and Open Burch Retropubic Urethropexy

Dunn¹,

Ellerkmann²,

Thornton³

et al. 2007

Journal of Pelvic Medicine and Surgery

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Objective: To compare objective and subjective medium-term cure rates of intraperitoneal laparoscopic colposuspension with that of open Burch colposuspension.Study Design: We retrospectively reviewed operative findings from all Burch colposuspension cases (n ‫؍‬ 92) done between January 1, 1997 and January 1, 2001 at the Greater Baltimore Medical Center. In subjects available for follow-up evaluation (n ‫؍‬ 47), we also compared the cure rate in both groups as assessed by physical examination, urodynamic evaluation, and validated questionnaire (Incontinence Impact Questionnaire and Urinary Distress Inventory). Results: The mean times to follow-up were 31.2 months (range, 15-72). At last follow-up, 21 of 24 (87.5%) of the laparoscopic and 20 of 23 (87%) of the Burch colposuspension groups were continent by urodynamic evaluation and standing cough stress test. Subjective cure rate was similar between groups (88% vs. 83%). Conclusion: Transperitoneal laparoscopic colposuspension, compared with open Burch colposuspension, resulted in similar medium-term cure rates.

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“…Mesh reinforcement is thought to add durability to laparoscopic colposuspension. The synthetic mesh is held in place with tackers, which avoids laparoscopic suturing within the confined pelvic space 3 . A study involving 5‐year follow up of laparoscopic colposuspension with synthetic mesh and staples, showed an initial success rate of 90% and 5‐year cure in 88% 4 …”

Section: Discussionmentioning

confidence: 99%

“…The synthetic mesh is held in place with tackers, which avoids laparoscopic suturing within the confined pelvic space. 3 A study involving 5-year follow up of laparoscopic colposuspension with synthetic mesh and staples, showed an initial success rate of 90% and 5-year cure in 88%. 4 We are not aware of any previously reported case of mesh erosion into the bladder following laparoscopic colposuspension.…”

Section: Discussionmentioning

confidence: 99%