[Laparoscopic transperitoneal colposuspension modo Burch in stress incontinence in women. A comparison of early and late results].

The female stress urinary incontinence is recognize in 15-20% of women between 40 and 70 years of age. Surgical treatment of stress urinary incontinence has been performed via several techniques with a wide range of success rates. At present, most surgeons use the Burch colposuspension as the primary incontinence operation. In the years 1996-2000, 58 women (age range 38-70 years) were evaluated for the treatment of laparoscopic Burch colposuspension. Preoperative diagnostics were based on: physical, gynecological and neurological examination, sonography, cystography and urodynamic study. The follow up was 18.5 months (range 6-24 months). The success rate of this procedure was 91.4% after 6 months and 69% after 24 months. Postsurgical outcomes following laparoscopic colposuspension in relation to type of SUI was 92% in type II, 90.9% in type III after 6 months and 72% in type II, 69.7% in type III after 24 months. In younger women (38-55 years of age) a good result was 94.1% after 6 months and 79.4% after 24 months. In older women (56-70 years of age) was respectively 91.6% and 54.2%. The success rate of laparoscopic operation after 24 months was 81.8% in women with additional hormonal therapy and only 53% in patients without supplementary estrogen therapy. The mean operative time was 45 minutes (range 30-120 min.) and mean hospitalization time was 3.2 days (range 2-5 days). There were no postoperative complications. The average loss of blood was estimated to 30 ml. Transperitoneal laparoscopic colpo-suspension produced high early success rate. The type of intensification of stress urinary incontinence and amount of births had no influence on good result percentage. The efficiency of the laparoscopic colposuspension was significantly worse in older women without additional hormonal therapy.