PROSPECTIVE COMPARISON OF LAPAROSCOPIC AND TRADITIONAL COLPOSUSPENSIONS IN THE TREATMENT OF GENUINE STRESS-INCONTINENCE

Objective. To compare prospectively the results of laparoscopic and tr aditional colposuspensions in the treatment of genuine stress incontin ence and to evaluate the efficacy, technique, and functional and anato mical changes after these two procedures. Materials and methods. Ninet y-two patients with urodynamically proven genuine stress incontinence participated in this study, with 46 patients randomly allocated to lap aroscopic colposuspension, and the other 46 patients to the traditiona l procedures. All patients had repeat studies at least 3 months after operation. Results. The bladder neck position was significantly elevat ed after operation either at rest or during straining in both groups ( all p<0.001): but it uas higher in the traditional group than the lapa roscopy group during straining (p<0.05). Comparison of urodynamics bef ore and after operation in both groups showed significantly increased minimal urethral resistance and improved pressure transmission ratios at the proximal urethra (Q(2)). The blood loss was less in the laparos copy group. The duration of bladder drainage after laparoscopic colpos uspension was shorter, and was not affected by subsequent laparotomy. The operative time was almost the same. The success rate of the laparo scopy group was lower than that of the traditional group (80.4% vs. 95 .6%, p=0.044). The complication rates were 10.8% and 17.4% respectivel y. Conclusion. Laparoscopic colposuspension is an effective method for the treatment of GSI, as documented by anatomical and functional asse ssments. However, the success rate is still lower than for the traditi onal procedure.