A three-armed randomized trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using sutures and laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence.
OBJECTIVE
To compare open Burch colposuspension using sutures (OC) with laparoscopic colposuspension using sutures (LCS) and laparoscopic colposuspension using mesh and staples (LCM) in women with stress urinary incontinence.


METHODS
Prospective randomized trial.


METHODS
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.


METHODS
Women with genuine stress urinary incontinence or mixed incontinence with a predominantly stress component attending the Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.


METHODS
The women were assessed objectively using a 48-h frequency-volume chart, a 48-h pad test and a standardized stress test. Subjectively, the women were assessed by a questionnaire including influence on quality of life. The women were randomized to OC using sutures (n = 79), LCS (n = 53) or LCM (n = 79). Anaesthesia/operation time, blood loss, complications and other related surgical parameters were compared. Main outcome measures. Objective and subjective cure rate.


RESULTS
Objective cure rates 1 year after surgery were significantly higher in the OC and LCS groups compared to the LCM group analyzed by a standardized stress test. Subjective findings were in concordance with the objective results. Performing an OC was less time consuming than performing a LCS and resulted in more blood loss compared to the two laparoscopic techniques. Patients in the LCM group had a shorter duration of catheter use and hospital stay.


CONCLUSIONS
The use of sutures, irrespective of whether the surgical approach was laparoscopic or open surgery, was superior to the laparoscopic mesh and staple technique.
Ankardal
Maud
M
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, S-413-45 Göteborg, Sweden. maud.ankardal@obgyn.gu.se
Milsom
Ian
I
Stjerndahl
Jan-Henrik
JH
Engh
Marie Ellström
ME
D000328:Adult; D000368:Aged; D003127:Colposcopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013526:Surgical Mesh; D017792:Surgical Stapling / Q000379:methods*; D013537:Sutures; D013548:Sweden; D016896:Treatment Outcome; D014463:Ultrasonography; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014563:Urodynamics; D014596:Uterine Prolapse / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*