Long-term results of laparoscopic Burch urethropexy.
OBJECTIVE
To evaluate the long-term efficacy of laparoscopic Burch urethropexy.


METHODS
Pilot study.


METHODS
Private practice.


METHODS
Thirty-five consecutive women (average age 45.5 yrs, average parity 2.3, average weight 67.7 kg) treated for genuine stress incontinence between May 1992 and July 1994.


METHODS
Urethropexy was performed with curved needle suturing in 7 women, straight needle suturing in 5, and Stamey needle suturing in 23. Twenty-five (71.4%) patients had concomitant pelvic surgery.


RESULTS
Wilcoxon two-sample, chi2, and Fisher's exact tests were performed to determine which variables were significantly associated with surgical success. Average operating time was 190 minutes, hospitalization 24 hours, and catheterization 5 days. The cure rate of stress incontinence was 89% 3 months and 86% 1 year after surgery. At average follow-up of 34 months, only 68.6% of patients reported complete or almost complete cure, 11.4% were improved, and 20% were complete failures. The only operative variable approaching statistical significance for predicting surgical success was type of suture needle (p = 0.07), with the Stamey needle group having the highest cure rate. Women who were cured or almost cured had a significantly shorter follow-up than those who were improved or failures (p = 0.001).


CONCLUSIONS
The success rate of laparoscopic Burch urethropexy compares with that of open Burch procedure at 1 year, but drops considerably thereafter.
Lobel
R W
RW
Albany Medical College, 47 New Scotland Avenue, A-74, Albany, NY 12208, USA.
Davis
G D
GD
D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008875:Middle Aged; D009339:Needles; D010865:Pilot Projects; D013536:Suture Techniques; D013997:Time Factors; D017211:Treatment Failure; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000601:surgery*