[Technic of percutaneous anterior colpopexy under endoscopic control for orthostatic and urinary stress incontinence in women (Stamey's operation)].

Percutaneous anterior colpopexy, as described by Stamey, constitutes a simple, reliable method for treatment of orthostatic and stress incontinence of urine in women. As with all operations destined to correct this infirmity, its aim is to replace the bladder neck and initial part of urethra into spaces subject to pelvic pressure. The principle of the operation consists of solidly attaching the whole thickness of particularly the para-cervicourethral vagina fibrous layer to the anterior abdominal wall by means of two solid monofilament threads of caliber 2, scissoring on the threads being prevented by insertion of a 1 X 0.5 cm vascular prosthesis. The operation mainly involves a vaginal approach: the vaginal incision in T exposing the bladder neck. Two abdominal incisions 2 cm in length and avoiding the aponeurosis are made 1 cm above the pubis from one side of the median line to the other. These allow Stamey's needles to be passed behind the symphysis up to the vaginal incision under endoscopic control. Cystoscopy is an essential part of surgery since it allows verification of good positioning of thread exactly at the bladder neck level and of the quality of the hyperelevation of posterior lip of bladder neck obtained. As effective as other retropubic anterior colpopexies, this procedure under endoscopic control has the major advantage of avoiding opening of Retzius space, with its inevitable morbidity, and of being possible without difficulty in previously operated patients. It should undoubtedly be included in the therapeutic armament used for this frequent infirmity.