[Comparison of biomechanical properties of the vaginal fixation in bladder neck suspensions according to the Burch technique and a percutaneous technique].
Bladder neck suspension or colpo-suspension can be performed via retropubic or percutaneous transvaginal approaches. A higher success rate is observed for retropubic procedures. One of the hypotheses proposed, but not yet verified, is that the retropubic approach allows better quality vaginal fixation than the percutaneous approach.


OBJECTIVE
The objective of this study was to compare the biomechanical properties of vaginal fixation according to the Burch procedure and according to a percutaneous technique (Vesica; Boston Scientific).


METHODS
We performed bladder neck suspension according to the Burch technique (2 points) on the left and according to the Vesica percutaneous technique on the right, on 6 fresh cadavers (mean age 8-5 years), using the same suture material. Vaginal fixations were subsequently excised. The depth of penetration into the vagina was measured and a computerized traction test (Lloyd Instruments, France) was performed on these fixations. The maximum force of traction before rupture was measured.


RESULTS
No significant difference was demonstrated for any of the measurements.


CONCLUSIONS
Vaginal fixation of bladder neck suspension performed according to the Burch technique or via a percutaneous technique (Vesica) present equivalent biomechanical properties.
Traxer
O
O
Service d'Urologie, Hôpital Tenon, Paris, France.
Haab
F
F
Anidjar
M
M
Gattegno
B
B
Cussenot
O
O
Thibault
P
P
D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D001743:Urinary Bladder / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000601:surgery*