Comparison between Extraperitoneal Laparoscopic Burch Colposuspension Using Mesh and Tacker and Open Burch Procedure

Kang, Jeong Pyo

Abstract

PURPOSE
A Laparoscopic Burch colposuspension has rapidly become one of the primary surgical treatment options for genuine stress urinary incontinence (GSI). An extraperitoneal laparoscopic Burch procedure using polypropylene mesh and Tacker was compared with a open Burch procedure to evaluate the efficacy of this procedure.
MATERIALS AND METHODS
A retrospective study of 61 consecutive cases diagnosed with GSI, and a subsequent followed up for 24 months or even longer (range: 24-40 months) were conducted. These evaluations were compared with 28 open Burch procedures during the same time period. All patients were assessed for their previous medical history, physical examination, cough stress test, transperineal ultrasonography, urethrocystoscopy, filling cystometries and urethral pressure profiles at both rest and strain.
RESULTS
The overall success rate of the two methods was similar. The results showed that an extraperitoneal laparoscopic Burch operation reduced the duration of catheter drainage (1.4+/-0.8 days versus 3.6+/-1.2 days), hospital stay (2.2+/-1.1 days versus 7.8+/-1.5 days), and operation time (48.2+/-18.4min. versus 57.4+/-20.2min.) compared to the open Burch operation (p<0.05). However there were no significant differences in the complication rates.
CONCLUSIONS
Extraperitoneal laparoscopic Burch colposuspension using a mesh and Tacker provides a durable resolution for GSI with low risk of conversion, short hospitalization, operation time and few complications. Further clinical assessment is necessary to evaluate its long-term feasibility.