Endoscopic vesical neck and uterovaginal suspension for cystocele prolapse repair.

The therapeutic surgical approach to cystourethrocele and pelvic organ prolapse with or without urinary incontinence usually involves hysterectomy and anterior colporrhaphy. This is associated with a high degree of failure and may cause the appearance of de novo urinary incontinence because of functional disturbances of the lower urinary tract. We report a new combined needle suspension of bladder neck and uterine isthmus to correct uterovaginal prolapse and urinary incontinence without the need for hysterectomy. This endoscopic procedure is minimally invasive, safe, effective and simple. The operative approach is flexible, well tolerated and could be adapted to an outpatient setting. It is designed to restore the functional pelvic anatomy without extensive operative dissection and anterior colporrhaphy.