The treatment of stress incontinence--is there a role for laparoscopy?

The laparoscopic colposuspension procedure has been performed by a relatively few urogynaecologists over the last 12 or 13 years. It is a procedure that takes time and skill to learn and is recognized as a level 3 minimal access procedure. Comparative studies between it and other surgical procedures are relatively few but would appear to suggest that it is less successful than open colposuspension or TVT in terms of curing USI. Adding to this the fact that TVT would appear to have, like the laparoscopic colposuspension, the advantages attached to a minimal access procedure, it is hard to see the procedure having a significant place in the treatment of USI in the longer term. It may well be that a few skilled practitioners will continue with the procedure, especially if performing other laparoscopic surgery at the same time.