Abstract
Objective: To compare the effectiveness of two different laparoscopic colposuspension procedures:
extraperitoneal approach using mesh fixed with tacks, and transperitoneal approach
using sutures. Study design: We conducted a retrospective study of all patients (n=64) who had undergone two different techniques of laparoscopic Burch colposuspension
without additional surgeries over a 6-year period. Thirty-six women underwent laparoscopic
transperitoneal colposuspension with using nonabsorbable sutures (group A), whereas
28 women underwent laparoscopic extraperitoneal colposuspension with using mesh and
preperitoneal balloon dissection technique (group B). Cure rate was assessed by simple
cystometry with a cough stress test in the standing position. Both groups were compared
with regard to cure rates, operative time, length of hospital stay, complications,
estimated blood loss, and total hospital charges. Results: The mean times to follow-up were 25.7 months in the group A and 27.3 months in the
group B (P=0.082). At last follow-up, 33 of 36 (91.7%) patients in the group A and 23 of 28
(82.1%) patients in the group B were continent (P=0.22). The other results were as follows for group A and B, respectively: average
duration of surgery, 58.1 compared with 46.8 min (P=0.001); average hospital stay, 2.05 compared with 1.57 days (P=0.02); the intraoperative complication rate, 8.3% compared with 7.1% (P=0.62). The total hospital charges for the group B were found significantly higher
(US$ 2234 versus US$ 1348, P=0.001). Conclusion: Although we found higher cure rates in laparoscopic colposuspension with the transperitoneal
approach using sutures than the extraperitoneal approach using mesh fixed with tacks,
there was no statistically significant difference between the two procedures. In comparison
with extraperitoneal mesh technique, lower cost is the superiority of the transperitoneal
suture technique.
Keywords
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Article info
Publication history
Accepted:
February 2,
2004
Received in revised form:
December 21,
2003
Received:
September 21,
2003
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
