Laparoscopic colposuspension: A short term urodynamic follow-up and a three-year questionnaire-study

Abstract

Background. The purpose of the study was to evaluate outcome, urodynamic correlates and adverse effects of laparoscopic colposuspension using polytetrafluoroethylene sutures. Methods. Eighty-five consecutive women with primary stress urinary incontinence at one university hospital were included in this prospective non-controlled study. During video-laparoscopic surgery, two polytetrafluoroethylene sutures were placed on each side of the urethra and fixed to the Cooper ligaments. Pre- and postoperative clinical and urodynamic evaluations, including pad-test, were performed. A mailed questionnaire was used to evaluate cure-rate and complication-rate three years after surgery. Results. At follow-up examination, we considered 62 of 76 women (82%) as being cured, ten (13%) improved, and four (5%) as being failures. The questionnaires were returned by 80 women; 41 (51%) considering themselves as cured and 31 (39%) improved, and eight women (10%,) as unimproved or minimally improved. Clinical outcome was not associated with alterations in urethral functional length or in urethral closing pressure. Short preoperative urethral functional length was associated with failure (p = 0.04). The incidence of new onset urge symptoms and of new onset recto/enterocele was 13% and 9% respectively. Conclusions. Laparoscopic colposuspension resulted in acceptable cure rate in short-, and medium long term evaluation. However, a decline in cure rate was observed. Cured women had significantly longer preoperative urethral functional length than women still leaking after surgery.