Long-term Results of RetropubicVesicopexy in the Treatment of Female Urinary StressIncontinence

Overview

Objective:
To evaluate long-term results of retropubic vesicopexy (e.g. direct suspension of theanterior and lateral walls of the bladder base) in the treatment of female stress urinary inconti-nence (SUI) caused by hypermobile urethra.Design: Retrospective clinical study.Setting: Department of Urology, Faculty of Medicine, University of P. J. Safarik, Kosice, Slovakia.Methods: From a total of 44 females operated on between 1985–1992, 41 (93%) were available forthe study (mean age 50 years, 28 pure SUI, 13 mixed incontinence). 18 (44%) patients had failedprevious incontinence surgery. Based on the data collected by a detailed questionnaire as a suc-cess cure and/or significant improvement (max. 1 pad/day) of SUI have been considered.Results: With a mean of 103 month follow-up period (48–160 months), 32 (78%) patients reported tohave their SUI cured, another 5 (12%) significantly improved. Both persistent (8/13, 62%) and denovo urge incontinence (5/28, 18%) have shown to the main reasons for “partial” satisfaction onlywith the outcome of surgery. Perioperative bleeding requiring blood transfusion was the onlyserious complication met with this procedure (2 patients).Conclusion: Long-term results of vesicopexy is comparable with the effect of standard retropubicprocedures like Burch colposuspension or MMK urethropexy. Technical simplicity, no risk ofosteitis pubis as well as persisting micturition problems may be considered the main advantagesof the procedure. Because of lower cure rate the procedure is less suitable for SUI type IIB.

Key words:
female stress urinary incontinence, surgical treatment, retropubic vesicopexy, longterm results