title: Evaluation of indication-specific genuine stress urinary incontinence procedures in a pelvic floor center.
abstract: OBJECTIVE
  The aim of this study was to assess the indication-related safety, feasibility, and efficacy of laparoscopic Burch colposuspension (LBC), open Burch colposuspension (OB), and midurethral sling (MUS), retropubic vaginal tape (TVT) and transobturator vaginal tape (TOT) procedures for surgical treatment of female stress urinary incontinence (SUI).
  
  
  METHODS
  Perioperative outcome was assessed in 321 patients treated for SUI by a single surgeon (LBC, n = 120; OB, n = 23; TVT, n = 129; TOT, n = 49) between April 2001 and December 2007 at a single center. Follow-up was available for 115 patients at 30, 40, and 26 months for LBC, OB, and MUS, respectively. The primary outcome was the objective continence measured by a negative cough stress test. The secondary outcome was the subjective continence measured by subjective perception of cure, the King's Health Questionnaire (KHQ), and visual analog score (VAS).
  
  
  RESULTS
  The LBC group had one (0.8%) intra-operative complication (bladder injury) and a mean operation time of 56.5 min. The objective and subjective cure rate associated with LBC was 90.3 and 71%, respectively. The OB group had three (13%) intra-operative complications and a mean procedure time of 44.6 min. The objective and subjective cure rate was 69.2 and 61.5%, respectively. MUS had 7 (TVT, n = 2; retropubic I-STOP, n = 5) procedure-related complications (5.4%) and an operation time of 19.8 min. The objective and subjective efficacy rate for MUS was 84.5 and 62%, respectively.
  
  
  CONCLUSIONS
  LBC was shown to be safe and feasible with a high objective and subjective success rate. Use of this minimally invasive procedure should be considered in patients with concomitant intra-abdominal pathology.
authors.affiliation: Department of Obstetrics and Gynecology, St. Vinzenz Hospital Dinslaken, Dr.-Otto-Seidel-Strasse 31-33, 46535, Dinslaken, Germany, koektuerk@web.de.
authors.forename: B
authors.initials: B
authors.lastname: Köktürk
authors.forename: B
authors.initials: B
authors.lastname: Uhl
authors.forename: G
authors.initials: G
authors.lastname: Naumann
mesh_terms: D034841:Abdominal Cavity; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000601:surgery; D011788:Quality of Life; D053825:Suburethral Slings / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*