Laparoscopic Colposuspension for Recurrent Stress Incontinence after Tension-free Vaginal Tape

Publication date: Available online 11 July 2018Source: Journal of Minimally Invasive GynecologyAuthor(s): Haider Jan, Vishalli Ghai, Ranee ThakarABSTRACTStudy ObjectiveTo demonstrate laparoscopic colposuspension for recurrent stress incontinence after failed tension-free vaginal tape (TVT).DesignA technical video showing laparoscopic colposuspension for previously surgically treated stress incontinence (Canadian Task Force classification III).SettingA university hospital.PatientA 58-year-old woman with previous TVT presents with recurrent stress urinary incontinence.Measurements and Main ResultsMidurethral slings have equivalent cure rates to the more invasive colposuspension. They are preferentially used for stress urinary incontinence despite a mesh erosion rate of 3.5% with 2.5% requiring further surgery, sling removal, or revision over 9 years 1, 2. Recent negative publicity concerning synthetic mesh tape has led to a resurgence of interest in mesh-free alternatives, including urethral bulking agents, rectus fascia slings, and colposuspension. Laparoscopic colposuspension is a well-established minimally invasive surgery that avoids synthetic mesh, with a quicker recovery, less scarring, and equivalent success to an open approach [3]. Bladder neck mobility is an important marker during selection of this technique. In this video, we demonstrate our transperitoneal technique of colposuspension in the case of failed TVT. This technique allows clear visualization of the operat...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research