Laparoscopic colposuspension eases recovery.(News)

MONTREAL -- Laparoscopic colposuspension performed by experienced surgeons has a cure rate similar to the open procedure, but patients experience a better recovery, according to a prospective, randomized controlled trial.

The multicenter British trial is the first reported series with enough power and follow-up to adequately compare the two techniques, said Tony Smith, M.D., who reported the results at the annual meeting of the International Continence Society.

Although differences in outcomes between the techniques were not statistically significant, "the data do suggest a trend toward women undergoing the open procedure having more pain initially, getting more wound infections, staying a little longer in hospital, and taking a little bit longer to get back to work," he said in an interview. However, while pain and infection appear to be reduced with laparoscopic colposuspension, this must be measured against the additional costs of this method, added Dr. Smith of St. Mary's Hospital, Manchester, England.

He compared laparoscopic colposuspension with business/economy class travel, saying "some people pay more for convenience, but they all get there in the end."

The researchers recruited 291 women with urodynamically proved stress urinary incontinence requiring colposuspension, then randomized them to the laparoscopic or open procedure performed at one of six centers. Each included surgeons with extensive experience in both techniques.

Before surgery, in addition to urodynamic testing, the women answered questionnaires on symptoms. Follow-up questionnaires were completed at 6 weeks post surgery, as well as at 6, 12, and 24 months. A pad test was performed at each visit, and urodynamic studies, which were performed routinely at 6 months post surgery, were repeated only if the pad test was positive, Dr. Smith said.

...