Comparison of open retropubic and laparoscopic colposuspension for treatment of stress urinary incontinence

Although endoscopic methods have become the preferred means of management for many diseases facing the genitourinary surgeon, a laparoscopic approach might be considered comparable or advantageous in select circumstances. In the literature, laparoscopists reporting their work have favored the transperitoneal approach; however, there are clear advantages and disadvantages to both transperitoneal and retroperitoneal laparoscopy. Intracorporeal suturing remains the most time-consuming aspect of reconstructive surgery, and research emphasis has been on suturing devices and novel anastomotic techniques. Laparoscopic pyeloplasty is efficacious and should be considered, particularly in the case of a capacious renal pelvis, crossing vessel, or failed previous endopyelotomy. Laparoscopic pyelolithotomy is uniquely suitable for patients with aberrant anatomy, such as a horseshoe kidney, and may be performed concurrently with pyeloplasty for ureteropelvic junction obstruction. The use of laparoscopic extravesical ureteral reimplantation awaits further development in both open and subtrigonal injection techniques. Its use in colposuspension is undetermined and requires further study as suturing technology improves. During laparoscopic exploration, it is possible to address intraoperative injuries to the ureter and bladder laparoscopically. In summary, laparoscopic surgery of the urinary tract is a "work in progress," but it offers promise for some of the most challenging of circumstances. As the technology advances and the clinical experience widens, the indications and contraindications for these techniques will be better established.

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“…Papasakelariou noted 91% continence rates in 32 patients at 2 years [77]. Miannay et al [78] saw 68% cure at 2 years in their series.…”

Section: Stress Urinary Incontinencementioning

confidence: 82%

A transperitoneal laparoscopic approach to endourology

Kaynan

Winfield

2001

Curr Urol Rep

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“…In a retrospective study, conducted by Miannay et al (16) comparing both techniques in 72 patients, a shorter surgical time was observed with open approach. However, patients reported a lower pain index with laparoscopic approach, requiring less postoperative analgesia.…”

Section: Discussionmentioning

confidence: 96%

Laparoscopic Burch surgery: is there any advantage in relation to open approach?

Bezerra¹,

Rodrigues²,

Seo³

et al. 2004

Int. braz j urol.

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Introduction: Surgery represents the main therapeutic modality for stress urinary incontinence. In incontinent patients with urethral hypermobility, the retropubic colposuspension by Burch technique is one of the surgeries that present better long-term results. Current trends towards performing minimally invasive techniques led proposing the Burch surgery through videolaparoscopy. The laparoscopic technique's long-term efficacy is a highly controversial issue. However, even if late results turn out to be satisfactory, the assumed advantages of laparoscopy (faster recovery, less pain, early return to daily activities, etc.) must be evident, in order to justify the use of this minimally invasive surgical access.Materials and Methods: We reviewed our records and analyzed the medical charts of 26 female patients who underwent Burch surgery by open approach and 36 female patients by laparoscopic approach, between May 1999 and February 2001. The satisfaction level, surgical complication rates, surgery length, hospital stay and return to daily activities were analyzed.Results: Mean age was 42 years, ranging from 27 to 68 years. Epidemiological data from both groups were not statistically different. Patients operated by laparoscopic route had a shorter hospital stay (p = 0.002) and a faster return to their daily activities (p < 0.001). However, there were no statistical differences in the following parameters: surgical time (p = 0.11), surgical complications (p = 0.98), patient satisfaction immediately (p = 0.77) and 90 days following surgery (p = 0.84), surgery acceptance (p = 0.85), indication of this surgery to a friend (p = 0.93) and score given to the procedure (p = 0.68).Conclusions: Even if the efficacy of both methods is similar, we did not observe significant advantages of laparoscopic surgery over open surgery, concerning the recovery in recent post-operative period.

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“…A laparoscopic approach to colposuspension avoids numerous disadvantages associated with open surgery, one being the aesthetic aspect with regard to the abdominal scar. Minimal invasive techniques in general enable shorter length of hospital stay, faster recovery and return to activity . Table shows published level 1 and 2 evidence relating to laparoscopic colposuspension.…”

Section: Methodsmentioning

confidence: 99%

“…Minimal invasive techniques in general enable shorter length of hospital stay, faster recovery and return to activity. [52][53][54] Table 1 shows published level 1 and 2 evidence relating to laparoscopic colposuspension. The recent Cochrane review about laparoscopic colposuspension included 22 randomized controlled trials.…”

Section: Laparoscopic Burch Colposuspensionmentioning

confidence: 99%

Burch colposuspension

Veit‐Rubin

Dubuisson

Ford

et al. 2019

Neurourology and Urodynamics

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AimsTo evaluate the historic and pathophysiologic issues which led to the development of Burch colposuspension, to describe anatomic and technical aspects of the operation and to provide an update on current evidence.MethodsWe have performed a focused literature review and have searched the current available literature about historic dimension, technical descriptions, and efficacy of Burch colposuspension.ResultsBurch colposuspension, performed either by an open or a laparoscopic approach, is an effective surgical treatment for stress urinary incontinence.ConclusionsIn current recommendations, Burch colposuspension remains an option for secondary treatment. Because midurethral slings have recently become under scrutiny, it may return as a first‐line treatment procedure. Both open and laparoscopic Burch colposuspension should therefore nowadays be provided in fellowship programs worldwide.

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Comparison of open retropubic and laparoscopic colposuspension for treatment of stress urinary incontinence

Cited by 29 publications

References 40 publications

A transperitoneal laparoscopic approach to endourology

A transperitoneal laparoscopic approach to endourology

Laparoscopic Burch surgery: is there any advantage in relation to open approach?

Burch colposuspension

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