Laparoscopic colposuspension using mesh reinforcement.
BACKGROUND: For patients with stress urinary incontinence, surgical reestablishment of the bladder neck has proved amenable to a laparoscopic approach, which shortens hospitalization and reduces tissue trauma. The use of mesh reinforcement to improve the durability of colposuspension can refine this proven procedure even further. METHODS: We performed laparoscopic Burch colposuspension on 54 patients with stress urinary incontinence and compared our results with those of other investigators. RESULTS: All patients reported resolution of incontinence postoperatively: 83.3% received no supplementary medication while 16.7% took antispasmodic-anticholinergic medications. Two cases required conversion to an open procedure. Hospital stay declined from 2.7 days (first quartile) to 1.9 days (last quartile) (average, 2.3 days). Complications were rare, and in a 28-month follow-up, no reoperations were required. CONCLUSION: Laparoscopic Burch colposuspension using mesh reinforcement provides durable resolution of stress incontinence with low risk of conversion, short hospitalization, and few complications.