Extraperitoneal laparoscopic bladder neck suspension using hernia mesh andtacker

Objectives. To report our initial experience with extraperitoneal bladder n eck suspension for female stress incontinence due to urethral hypermobility . Methods. Between September 1996 and September 1999, 35 patients (mean age 4 9.5 years) underwent extraperitoneal bladder neck suspension at our institu tion. An extraperitoneal space was created by a trocar-mounted balloon devi ce, and suspension was created using a 5-mm endoscopic hernia stapler and p olypropylene mesh. Results. The mean operative time was 39.5 minutes. In 2 patients, the bladd er was inadvertently perforated during the bladder neck dissection. The per foration was repaired by laparoscopic suture ligation. The mean urethral ca theterization and hospitalization time was 2.1 and 2.3 days, respectively. Urethral recatheterization because of temporary urinary retention was requi red in 11.4% of the patients. Symptoms of bladder instability were experien ced by 13.5% of the patients in the early postoperative period. A total of 28 patients (80.0%) reported that they were totally dry after a mean of 23. 2 months. Conclusions. Extraperitoneal bladder neck suspension using hernia mesh and a stapler seems to be an effective and safe procedure, with a shorter opera tive time, in selected patient groups. UROLOGY 56: 121-124, 2000. (C) 2000, Elsevier Science Inc.