Extraperitoneoscopic colposuspension using CO2 distension method

Purpose: To validate our experience in extraperitoneoscopic colposuspension for genuine stress incontinence, Materials and Methods: Between March 1995 and July 1996, 48 women who had g enuine stress incontinence underwent extraperitoneoscopic colposuspension i n our institute. After standard laparascopic surgery preparation, a 10 mm p uncture site was made midline just in the cm above the pubic hair line, and the extraperitoneal space was developed with the higher pressure of insuff lating CO2. A pair of sutures was inserted at the level of the midurethral and unrethrovesical junction with Cooper's ligament. Results: All of these patients underwent the same procedures. The average b lood loss was less than 50 mi, with a range from 10 to 200 mi, The operativ e time was from 20 to 90 min, with a mean time of 32 min. There nas one bla dder injury, 2 cases of voiding difficulties and 2 of detrussor instability in our series and the overall complication rate was 10.4%, So far, 45 of t he 48 patients are satisfied with the surgery. Conclusions: Laparoscopic Burch colposuspension is a practicable surgical p rocedure for managing stress incontinence. Extraperitoneal space was create d easily with the higher pressure of insufflating CO2. An extraperitoneosco pic approach can reduce the necessity of laparscopic suturing, Moreover, it avoids violating the peritonel cavity and reduces the potential risk of po stoperative adhesion formation and the discomfort resulting from pneumo-per itonium, Thus, extraperitoneal colposuspension affords an alternative to la paroscopic or abdominal retropubic colposuspension in well-selected patient s.