Long‐term patient‐reported outcomes after laparoscopic Burch colposuspension

Abstract

Background:The negative media attention surrounding vaginal mesh procedures has seen a rise in demand for minimally invasive non-mesh options for the treatment of stress urinary incontinence (SUI). The laparoscopic Burch colposuspension (LBC) is a non-mesh alternative to synthetic midurethral slings (MUS) with similar short-term outcomes. However, long-term outcomes are not well established. Aims:To evaluate the long-term outcomes of LBC for treatment of SUI in women. Material and Methods: One hundred and fifty-one cases of LBC were performed by a single surgeon over two private hospital settings between January 2010 and January 2016. Follow-up subjective outcomes were obtained in 137 cases (90.7%) utilising standardised questionnaires. Primary outcome was successful treatment of SUI, defined as subjective cure or significant improvement of stress incontinence symptoms. Secondary outcomes included new-onset or worsened symptoms of overactive bladder (OAB), voiding dysfunction, prolapse, and perioperative complications. Results: One hundred and thirty-seven patients were analysed with a mean follow-up of 50.6 months (range: 13-89 months). Primary outcome of successful treatment was achieved in 90.5% of women. New-onset or worsened symptoms of OAB was reported in 10.2%, with a further 8.8% of women experiencing symptomatic voiding dysfunction. Sixteen patients (11.7%) reported new-onset or worsening symptoms of prolapse. There were no major surgical complications.Conclusions: LBC is a safe and effective long-term treatment for SUI, with low failure rates and minimal adverse outcomes. It is a suitable alternative for women with contraindications to mesh or those having concomitant laparoscopic procedures. K E Y W O R D Sfemale, follow-up studies, humans, laparoscopy, stress/surgery, urinary incontinence

Evaluating Patient Preferences and Clinical Outcomes for Modified Laparoscopic Burch Colposuspension and Transobturator Tape Procedures in Stress Urinary Incontinence Treatment

“…Sivaslioglu et al and Bandarian et al reported similar results with operation time for the TOT procedure of 20 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) min and the mean hospital stay in the TOT group was 2.06 ± 1.03 days [5,17]. Ulmsten U. et Petros P. reported similar results in their study [13].…”

“…Regarding cure rate after the laparoscopic Burch procedure, our study reported a cure rate of 66.2% in the modified laparoscopic Burch group. In their research, Conrad et al reported higher subjective success rates, with 78.1% of patients reporting no symptoms of SUI at a mean follow-up of 50.6 months and 12.4% reporting significantly improved symptoms in the laparoscopic Burch group [ 18 ]. Yang et al described their high results with a laparoscopic Burch group with 116 of 155 women available at 1-year follow-up with an objective cure rate 94.8% (110/116) and a subjective cure rate 95.7% (110/116) [ 19 ], and Hong et al reported a 72.1% cure rate in their laparoscopic Burch group [ 20 ].…”

The outcome of patients with stress urinary incontinence combined with pelvic organ prolapse treated by mid‐urethral linear suspension

“…Burch is more traumatic, and may also be complicated by acute urinary retention, retropubic hematoma, and pubic osteitis, etc. It requires advanced operating skills and increases the incidence of prolapse of the posterior wall of the vagina and the fornix 12,13 . Therefore, the mid‐urethral linear suspension surgery has the clinical significance.…”

“…It requires advanced operating skills and increases the incidence of prolapse of the posterior wall of the vagina and the fornix. 12,13 Therefore, the mid-urethral linear suspension surgery has the clinical significance. The difference between mid-urethral linear suspension and Kelly plication, is making a hammock below the urethra and plicating the 'relaxed tissues at the vesical neck'.…”

Current Overview of Surgical Options for Female Stress Urinary Incontinence

“…Recently, Conrad et al reported that 90% of patients who underwent Burch colposuspension showed successful treatment with a mean follow-up of 50 months (13-89 months). They defined successful treatment as a subjective cure or significant improvement of SUI [23].…”