Comparison of Extraperitoneal Laparoscopic Burch Operation versus Raz Operation for Stress Urinary Incontinence

Kim, Yong Woo; Lee, Jeong Gu

Abstract

PURPOSE: Results of extraperitoneal laparoscopic bladder neck suspension(BNS) and that of Raz procedure for the correction of stress urinary incontinence (SUI) were analyzed retrospectively.
MATERIALS AND METHODS
Among 39 patients who underwent laparoscopic BNS for anatomical SUI, 28 patients had follow-up study at postoperative 6 months. All 87 patients who underwent Raz procedure were also followed up at postoperative 6 months.
RESULTS
Mean operation time in laparoscopic BNS was 138 min initially but, was shortened to 95 min. after using 'thick (5 mm) knot pusher'; whereas mean operation time in Raz group was 56min. Return to normal voiding and mean duration of hospital stay were possible in 1.2 days and 2.6 days in laparoscopic group and 11.9 days and 4.5 days in Raz group with significant difference between 2 groups. Amount of residual urine at discharge was less than 100cc In all except 1 case in laparoscopic group(27/28, 96%). However in Raz group, 35 patient(40%) still showed residual urine of more than 1 00ml at the time of discharge. Postoperatively, voiding difficulty was noted in 3, frequency in 15, bleeding in 2, dyspareunia and bladder stone in 1 case for Raz group; In laparoscopic group, frequency was noted in 3, voiding difficulty in 2, needs of transfusion in 2 cases. 26 of 28 patients(85%) were completely dry or Improved in laparoscopic group; 82 of 87 patients(93%) In Raz group also showed complete dryness of improvement without significant difference in success rate between 2 groups.
CONCLUSIONS
From our results, laparoscopic bladder neck suspension could shorten the duration of hospital stay and time to regaining normal voiding with early catheter removal. High success rate was also comparable to those of Raz operation. Laparoscopic BNS could applies as erective treatment modality for the surgical correction of anatomical stress urinary incontinence with its less invasiveness and early return to normal activities compared with the Raz procedure.