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Robotic Burch colposuspension: a surgical case and instructional video

Abstract

Introduction and hypothesis

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.

Conclusion

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.

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References

  1. 1.

    Lapitan MCM, Cody JD (2012) Open retropubic colposuspension for urinary incontinence in women. Cochrane Database Syst Rev 6, CD002912. doi:10.1002/14651858.CD002912.pub5

  2. 2.

    Bai SW, Jeon MJ, Kim JY, Chung KA, Kim SK, Park KH (2002) Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J 13:256–260

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Consent

Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

Conflicts of interest

Dr. Francis is a speaker for Astellas Pharma Inc. Dr. Ostergard has provided services in the form of medicolegal consultation and testimony and is a speaker for Astellas Pharma Inc. All other authors report no conflict of interest.

Author information

Correspondence to Sean L. Francis.

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Francis, S.L., Agrawal, A., Azadi, A. et al. Robotic Burch colposuspension: a surgical case and instructional video. Int Urogynecol J 26, 147–148 (2015) doi:10.1007/s00192-014-2471-1

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Keywords

  • Burch colposuspension
  • Robotic surgery
  • Stress urinary incontinence
  • Surgical management of stress urinary incontinence