This is also a very old debate, still open, and not only concerning laparoscopic repair of POP, but any technique. In our early experience in the 90s, we tried to reproduce exactly what was done with laparotomy. At that time, the rule in Europe was to perform a Burch colposuspension systematically at the time of SCP except when the patient had had it previously. I just want to remind you that Burch colposuspension was known to induce enteroceles in a high rate of cases and these enteroceles required SCP to be cured. This sequence was not rare. Later on, we stopped performing SUI repair procedures in patients who had neither symptomatic nor occult SUI.

At the end of the 90s, Burch colposuspension was quickly replaced by vaginal suburethral slings of various kinds: TVT, TOT, minislings. Thus, performing the whole procedure through the same laparoscopic approach was not possible anymore and all urogynecologists had to become vaginal surgeons for SUI repair.

Three recent publications summarize the state of art in 2016.

Salerno in 2016 [1] selects patients as we do, according to a preoperative stress test into three groups: SUI, occult SUI and negative stress test. The first two undergo a sling operation. He finds that SUI was cured in 77% of patients of the first two groups and de novo SUI appeared in 19% of the non sling patients. De novo urge incontinence appeared in respectively 9%, 15% and 19% of patients of each group. Quality of life questionnaires UDI-6 and UIQ-7 improve in all groups after 3 years of follow up. The authors feel happy with these results and estimate that their strategy is correct.