Experience with suprapubic vesicourethral suspension and endoscopic suspension of the vesical neck for stress urinary incontinence in females.

The morbidity and efficacy of suprapubic vesicourethral suspension and endoscopic suspension of the vesical neck for correction of stress urinary incontinence in females were analyzed. Between 1974 and 1981, 41 women were treated with the former procedure and between 1981 and 1984, 50 were treated with the latter. The two treatment groups were well matched with respect to age, duration of incontinence, grade of incontinence, previous unsuccessful anti-incontinence surgical procedures and experience of the operating surgeon. The incidences of excessive intraoperative blood loss, postoperative abdominal complications and late complications in the suprapubic suspension group were 7, 14 and 2 per cent, respectively, and in the endoscopic suspension group, zero, zero and 2 per cent, respectively. The mean duration of postoperative hospitalization in the suprapubic suspension and the endosocpic suspension groups were 9.4 and 6.9 days, respectively. Seventy-three per cent of the patients treated by suprapubic suspension (mean duration of follow-up 71 months) and 86 per cent of the patients treated by endoscopic suspension (mean duration of follow-up 19 months) were cured. We conclude that the morbidity of endoscopic suspension is less than that of suprapubic suspension and that the early results of endoscopic suspension are equivalent.