Laparoscopic retropubic urethropexy

We evaluated a simplified extraperitoneal retropubic bladder suspension using balloon distention and mesh suspension in 100 patients to determine operating time, anesthesia, morbidity, voiding time, length of hospital slay, cost, and patient satisfaction. All cases were performed by the same surgeon. The majority of women were medium build; 28 were obese, and 17 thin. Operating time varied little, with most 89 procedures requiring less than 30 minutes. Either epidural anesthesia or general anesthesia can be used. There were two hematomas and six bladder entries. Voiding time varied from 4 hours up to 2 days, with 87% of patients voiding in less than 18 hours. Hospital stay was less than 24 hours for all but two patients, except when other procedures were associated with the bladder suspension. The average cost of the outpatient procedure was $3220.00, and inpatient surgery, with a 3-day stay, averaged $6370.00. Ninety-one patients reported they were continent. Nine were classed as failures, of whom six were satisfied with the result. Extraperitoneal, retropubic, bladder mesh suspension results in a durable repair, and is associated with minimal operating time and morbidity and maximum patient satisfaction and clinical benefit.