Anterior urethropexy according to lapides: how effective is it in the treatment of genuine female stress incontinence?

OBJECTIVES

Anterior urethropexy, introduced by Lapides, is a retropublic suspension procedure in which the anterior urethral wall is secured to the posterior surface of the symphysis pubis by full thickness trans-urethral sutures. Little information exists in the literature about its effectiveness and morbidity as a surgical treatment option for female stress incontinence. In this study, the outcome of this technique in the treatment of anatomic genuine stress urinary incontinence has been evaluated.

METHODS

Thirty women with urodynamically-proven anatomic stress urinary incontinence underwent anterior urethropexy and 27 of them were followed up for a minimum of 12 months with a mean period of 28.9 months.

RESULTS

A complete dry rate of 52% and a significant improvement of 11% were achieved at the mean follow up period. No postoperative retention or other significant complication was observed in the study group. De novo urge incontinence was noted in 2 patients and managed by anticholinergic treatment.

CONCLUSION

Anterior urethropexy is found to be a safe retropubic suspension technique with a considerably low morbidity but revealed a relatively lower success rate compared other open bladder neck suspension techniques.