NON INCISION PERCUTANEOUS NEEDLE COLPOSUS PENSION TO COOPERS LIGAMENT

Objective:To evaluate the feasibility safety and results of a new proc edure of treatment of genuine urinary stress incontinence:needle percu taneous colposuspension to Cooper's ligament. Study design:From June 1 994 to December 1995, 63 patient's had a needle percutaneous Cooper's ligament colposuspension for stress urinary incontinence (USI). The me an age of the patients was 48 years (range:32 to 80). Fourteen patient s were menopausal (22,2 %). The mean parity was 2,7 (range 0 to 10). A ccording to Blaivas and Olsson classification of USI, 6 patients had t ype 0, 32 type 1, 22 type 2 and 3 type 3, Fifety-eight patients had pr eoperative urodynamic control. Results:The procedure was performed in 63 patients (100 %). The mean operative time was 20 minutes (range 15 to 30). Peroperative complication:hemorrhagia in one case (1,5 %). Pos toperative complication rate was 12,7 % including seven urinary infect ions. The mean follow-up of the patients was 8 months (range:6 to 17). By subjective parameters, 55 patients were cured (87,3 %). Only 38 pa tients had postoperative urodynamic control including the 8 patients w ith failure of the procedure. Among these 8 patients, I had clinical f ailure with normal urodynamic control, 2 had vesical instability and 5 had a persistance of USI confirmed by urodynamic control. Conclusion: Needle percutaneous colposuspension to Cooper's ligament appears as fe asible and safe technique to cure USI. The interest of this new proced ure of colposuspension is ifs fixation to the Cooper's ligament using the vaginal approach. Priliminary results are good, however longer fol low-up is necessary to validate this new technique.