Summary:
Objective: To evaluate long-term results of retropubic vesicopexy (e.g. direct suspension of the
anterior 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 for
the study (mean age 50 years, 28 pure SUI, 13 mixed incontinence). 18 (44%) patients had failed
previous 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 to
have their SUI cured, another 5 (12%) significantly improved. Both persistent (8/13, 62%) and de
novo urge incontinence (5/28, 18%) have shown to the main reasons for “partial” satisfaction only
with the outcome of surgery. Perioperative bleeding requiring blood transfusion was the only
serious complication met with this procedure (2 patients).
Conclusion: Long-term results of vesicopexy is comparable with the effect of standard retropubic
procedures like Burch colposuspension or MMK urethropexy. Technical simplicity, no risk of
osteitis pubis as well as persisting micturition problems may be considered the main advantages
of 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, long
term results
|