title: Robotic Burch colposuspension: a surgical case and instructional video.
abstract: OBJECTIVE
  The Burch colposuspension is a well-studied and proven surgical treatment for stress urinary incontinence without intrinsic sphincter deficiency. The advent of the minimally invasive mid-urethral sling has given rise to diminished surgical experience in performing the Burch. Recent anti-mesh media and FDA notifications have caused patients to demand mesh-free surgery, resulting in an opportunity for the resurgence of the Burch procedure. The objective of this video is to demonstrate surgical technique and instruction for a robotic Burch colposuspension as well as recommendations for successful completion of the procedure. Additionally, the video reviews and illustrates pertinent surgical anatomy regardless of approach.
  
  
  METHODS
  The patient is a 53-year-old woman who presented with symptoms of vaginal pressure, urinary incontinence, and constipation. She had symptoms and urodynamics consistent with mixed urinary incontinence without intrinsic sphincter deficiency and had been treated with antimuscarinics for overactive bladder. On examination she was found to have stage II prolapse. She desired surgical management of both her prolapse and stress incontinence.
  
  
  CONCLUSIONS
  Robotic Burch colposuspension can be completed in a safe and effective manner and should be considered as an option for patients in whom an anti-incontinence procedure is indicated and who are already undergoing robotic surgery.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Women's Health, University of Louisville, Louisville, KY, USA, seanf000@gmail.com.
authors.forename: Sean L
authors.initials: SL
authors.lastname: Francis
authors.forename: Anubhav
authors.initials: A
authors.lastname: Agrawal
authors.forename: Ali
authors.initials: A
authors.lastname: Azadi
authors.forename: Donald R
authors.initials: DR
authors.lastname: Ostergard
authors.forename: Nicolette E
authors.initials: NE
authors.lastname: Deveneau
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012371:Robotics; D014550:Urinary Incontinence, Stress / Q000601:surgery*