A comparison of endoscopic suspension of the vesical neck versus anterior urethropexy for the treatment of stress urinary incontinence.

Endoscopic suspension of the vesical neck has been reported to be as effective as anterior urethropexy in the treatment of female stress urinary incontinence. We compared our first 29 patients treated with endoscopic suspension of the vesical neck between 1982 and 1985 to our last 21 patients treated with anterior urethropexy between 1979 and 1985. Both groups were comparable in regard to age, parity, duration of symptoms and previous surgery for stress urinary incontinence. All patients underwent thorough preoperative urodynamic testing. Endoscopic suspension of the vesical neck successfully cured stress urinary incontinence in 26 patients (90 per cent), while anterior urethropexy resolved the incontinence in 20 (95 per cent). Of the 3 failures of endoscopic suspension 2 probably were related to technique or material failure. Hospitalization was reduced for endoscopic suspension versus anterior urethropexy (mean 4.04 versus 6.00 days, respectively). The most common complication after endoscopic suspension of the vesical neck was transient urinary retention (34 per cent). We conclude that endoscopic suspension of the vesical neck is an effective method to treat stress urinary incontinence, and that it also reduces hospital stay and postoperative recovery.