Randomized comparison of Burch urethropexy procedures concomitant with gynecologic operations.
OBJECTIVE
We compared the success of laparoscopic Burch colposuspension with the laparotomic Burch colposuspension for the treatment of genuine stress incontinence (GSI) concomitant with gynecologic operations.


METHODS
Fifty-two women with symptoms of GSI, also requiring additional gynecologic operations, were randomly assigned to undergo laparoscopic (n = 26) or laparotomic (n = 26) Burch colposuspension. For all patients complete histories were taken and physical examination, urinalysis, urine culture, multi-channel urodynamics with cystometry, uroflowmetry, and measurement of Valsalva leak-point pressure were performed. Variables analyzed included: age, surgical time, length of catheterization, number of days in hospital, and complications.


RESULTS
Both groups were similar in age, parity and menopausal status. Valsalva leak-point pressure significantly increased in the laparoscopy group after the operation. There were no statistical differences in other urodynamics in both groups. The mean operating time in the laparoscopy group was longer than in the laparotomy group. The laparoscopy group required a significantly shorter hospitalization and catheterization than the laparotomy group. The success and complication rates did not differ significantly for both groups.


CONCLUSIONS
The laparoscopic approach for the treatment of GSI in patients requiring additional gynecologic procedures is associated with a shorter duration of hospital stay compared with the abdominal approach.
Ustün
Yusuf
Y
Department of Gynecology and Obstetrics, Ankara University Faculty of Medicine, Ankara, Turkey. ustunyus@yahoo.com
Engin-Ustün
Yaprak
Y
Güngör
Mete
M
Tezcan
Sevgi
S
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D014636:Valsalva Maneuver