To assess six-month and three- to four-year patient-oriented outcomes after laparoscopic Burch retropubic urethropexy.Twenty-two women with urodynamically proven genuine stress incontinence with urethral hypermobility underwent laparoscopic Burch retropubic urethropexy. Preoperatively, all 22 women completed a questionnaire concerning their incontinence. Postoperative measures of symptoms of incontinence, impact of incontinence on daily activities and patient satisfaction were assessed at six months and three to four years postoperatively. In those women who were followed, the questionnaire data at the three-time points (preoperative, six months and three to four years) were compared.Thirteen women (59%) completed postoperative questionnaires at six months and three to four years. When compared to preoperative data, there was a significant improvement in symptoms of stress incontinence at six months (P = .0005) and at three to four years (P = .002). There was also a significant reduction in limitations on daily activities at six months (P = .0005) and at three to four years (P = .0005) as compared to preoperative data. Twelve of the 13 women considered their surgery successful at six months and at three to four years.After laparoscopic Burch retropubic urethropexy, there was a significant improvement in patient-oriented outcomes, including complaints of incontinence and functional status.
Vaginal agenesis is a rare condition that can be treated successfully with a variety of nonoperative as well as surgical procedures. The difference between most of the surgical techniques lies in the material used to line the newly created canal. Skin grafts, peritoneum, and amnion have all been reported for this purpose. In the present study, four women with vaginal agenesis underwent surgical construction of an artificial vagina using Interceed Absorbable Adhesion Barrier to cover an inflatable stent placed within the neovagina. There were no intraoperative or postoperative complications, and epithelialization of the neovagina was complete by 3-6 months. All four subjects were satisfied with the results of the surgery and none of the women reported difficulty complying with postoperative care. This modification of the Abbe-McIndoe technique does not require a separate operative procedure to harvest a lining for the neovagina. The use of Interceed may reduce the cost, operative time, and morbidity associated with other vaginoplasty techniques.
