Treatment of urinary stress incontinence by percutaneous colposuspension: an unsatisfactory technique.

Objective: The objective of this study was to evaluate the results of a per cutaneous needle colposuspension technique with bone fixation (Vesica syste m) in the treatment of female urinary stress incontinence (USI) of the woma n, with a minimum follow-up of one-year. Material and Methods: 34 women aged 35 to 86 years (mean: 62 years) were tr eated for USI due to bladder neck hypermobility according to the Vesica tec hnique. All patients had a positive preoperative Bonney manoeuvre without s phincter incompetence on urethral pressure profile. Results: Overall, 1 year postoperatively, 9 patients (26%) were completely dry and did not wear any protection, 19 (56%) were improved, but still pres ented occasional leaks and 6 (17%) were considered to be failures. Physical examination revealed postoperative leaks in 24 patients with recurrence of hypermobility and positive Bonney manoeuvre in every case. There was one s ubcutaneous abscess and 2 cases of persistent pain at the bone implant site . No cases of bone infection or screw explantation were observed. No cases of retention beyond the 3rd postoperative day were observed. Conclusion: The percutaneous colposuspension technique gives disappointing results at one year due to recurrence of urethral hypermobility in every ca se.