title: Long-term results of laparoscopic Burch urethropexy.
abstract: 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.
authors.affiliation: Albany Medical College, 47 New Scotland Avenue, A-74, Albany, NY 12208, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Lobel
authors.forename: G D
authors.initials: GD
authors.lastname: Davis
mesh_terms: 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*