Endoscopic colposuspension with simplified extraperitoneal approach.

The retropubic colposuspension (Burch procedure) has been proven an effective treatment for female genuine stress urinary incontinence. During this decade, laparoscopic approach has gained access in continence surgery also. Endoscopic colposuspension can be performed either extraperitoneally or transperitoneally. If there is no need for intra-abdominal procedures the extraperitoneal approach for colposuspension is feasible. Generally a balloon dissection is used to develop the extraperitoneal space, but here we present a modified technique where no balloon is needed. This modification is easy to perform, quicker and decreases the costs of the procedure compared to transperitoneal approach. We also summarize the results of our first 46 patients, 24 of which were operated extraperitoneally and 22 by transperitoneal approach with concomitant pelvic surgery.