Laparoscopic Burch urethropexy in a private clinical practice.

STUDY OBJECTIVE

To determine the effectiveness of laparoscopic Burch urethropexy in a private practice setting.

DESIGN

Prospective, observational study (Canadian Task Force classification II-2).

SETTING

Private practice.

PATIENTS

Fifty-one consecutive women with stress urinary incontinence (15 genuine stress urinary incontinence, 36 concomitant degrees of pelvic organ prolapse).

INTERVENTION

Laparoscopic Burch urethropexy was performed with sutures in 36 patients and with mesh and staples in 15, in combination with laparoscopic vaginal vault suspension, paravaginal repair, laparoscopic-assisted vaginal hysterectomy, and other procedures.

MEASUREMENTS AND MAIN RESULTS

Intraoperative complications occurred in 10% of cases; all were recognized and repaired laparoscopically. Operating time ranged from 55 minutes to 3 hours (median 2 hrs 25 min). Forty-four (86%) surgeries were done on an outpatient basis, five women required an overnight stay, and two were admitted. Forty-seven (93%) patients were discharged without a catheter; two had urinary retention requiring a catheter for 5 days. Follow-up ranged from 12 to 42 months (average 24 mo). Forty-eight women (94%) were cured, three (6%) failed therapy, and six (12%) developed de novo detrusor instability.

CONCLUSION

Burch urethropexy can be performed safely by laparoscopy in a private practice setting with success similar to that of open technique. Most intraoperative complications can be corrected laparoscopically with no increase in morbidity. (J Am Assoc Gynecol Laparosc 6(1):39-44, 1999)