Long-term success after open and laparoscopic colposuspension: a case-control study

Objective A decade after its development, laparoscopic colposuspension remains a controversial alternative to open colposuspension in the treatment of female genuine stress incontinence. Results from the few published randomized controlled trials vary considerably. The authors therefore intended to define long-term subjective and objective results in their own patient population. Design Clinical retrospective case-control trial. Setting Urogynaecology service of a tertiary hospital. Subjects 50 patients seen on average 3.3 years after laparoscopic colposuspension, matched with 50 women who had been followed up on average 3.4 years after open colposuspension. Intervention Standardized interview, translabial ultrasound imaging. Main outcome measures Incidence of urinary tract symptoms, bladder neck elevation and mobility, trigonal deformation, funnelling. Results Stress and urge incontinence were non-significantly more common after open colposuspension, with significantly less frequency and nocturia in the laparoscopic group (P = 0.02). Significantly more patients were completely asymptomatic after laparoscopic colposuspension (P = 0.03). On ultrasound imaging, open colposuspension appeared to more commonly result in permanent distortion of the trigone (P = 0.02), with significantly less bladder neck descent on Valsalva manoeuvre (P = 0.005). These parameters were independent of follow-up time. Conclusion It appears that, in the population assessed here, laparoscopic colposuspension seems to offer at least equivalent results when compared with open colposuspension.