Stress incontinence: a new endoscopic approach.

We describe our experience in using a new endoscopic technique for suspending the bladder neck and urethra in 16 patients with stress incontinence. The procedure was started by dissecting the retropubic space, first with a sound and then with a Foley catheter before passing an absorbable suture from the abdominal fascia to the bladder neck using an elbowed needle introduced into the bladder through the neck and exteriorized through the urethra. The dissection of the retropubic space helped to form postoperative adherences which fixed the bladder neck and the urethra firmly to the pubic symphysis. The technique is simple, it does not require vaginal surgery, and the incidence of complications is minimal.