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Objective: It is the therapeutical aim of urogynecology to correct urinary incontinence. Which advantages offers the use of the Endo-Stitch needle in Burch's pelviscopic colposuspension?, Methods: When extending the field of pelviscopic surgery, in a prospective study we performed Burch's pelviscopic preperitoneal colposuspension using the disposable Endo-Stitch suture instrument in 12 patients with stress incontinence grades 2 or 3. Clinical and urodynamic evaluations were performed before and 8.5 months after the pelviscopic operation., Results: Clinical and urodynamic follow-up examinations revealed continence in 10 (83%) out of 12 patients., Conclusions: Our preliminary experience suggests that the pelviscopic incontinence operation by means of the Endo-Stitch needle is a good alternative to abdominal colposuspension. Follow-up results of a large number of patients will have to prove advantages in contrast to conservative surgery.

Objective: To assess the influence of spinal anesthesia on bladder neck position and a clinical stress test in continent women., Methods: In a prospective investigation, 14 women underwent urodynamic, sonographic and clinical assessment during spinal anesthesia. Results were compared to those obtained immediately preoperatively in the same patient., Results: During spinal anesthesia, the bladder neck was found to be located significantly lower and more posterior, and in 4/7 parous patients (0/7 nullipara) the clinical stress test was positive., Conclusion: These data provide additional evidence for the importance of neuromuscular function in the etiology of pelvic floor dysfunction and genuine stress incontinence.

In 36 women with cystometric evidence of bladder instability we investigated the efficacy of intravesical instillation of oxybutynin. The intravesical application of oxybutynin had a significant effect regarding the reduction of pollakiuria and nocturia and an improvement of bladder capacity. No local or systemic side effects were noted.