Endoscopic suspension of vesical neck for urinary incontinence.

Surgically curable urinary incontinence in women is achieved by restoration of the vesical neck from a dependent position in the pelvis to one high behind the symphysis pubis. Endoscopic suspension, which accomplishes this by elevating the internal vesical neck on both sides with two permanent buttressed nylon loops is effective for correcting primary or recurrent stress urinary incontinence and even total incontinence in over 90 per cent of patients. Technical advantages over retropubic vesical neck suspensions include less postoperative morbidity, functional measurements and anatomic visualization of a restored vesical neck during the procedure, easy access to the surgically difficult pelvis, and simultaneous repair of significant rectoceles or substantial cystoceles through the same operative field.