Abstract
Purpose
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.
Similar content being viewed by others
References
Ulmsten U, Henriksson L et al (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7(2):81–85 discussion 85–86
de Leval J (2003) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44(6):724–730
Paraiso MF, Walters MD et al (2004) Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized trial. Obstet Gynecol 104(6):1249–1258
Carey MP, Goh JT et al (2006) Laparoscopic versus open Burch colposuspension: a randomised controlled trial. BJOG 113(9):999–1006
Dean N, Herbison P et al (2006) Laparoscopic colposuspension and tension-free vaginal tape: a systematic review. BJOG 113(12):1345–1353
Lapitan MC, Cody DJ, et al. (2005) Open retropubic colposuspension for urinary incontinence in women. Cochrane Database Syst Rev (3):CD002912
Alcalay M, Monga A et al (1995) Burch colposuspension: a 10–20 year follow-up. Br J Obstet Gynaecol 102(9):740–745
Kjolhede P (2005) Long-term efficacy of Burch colposuspension: a 14-year follow-up study. Acta Obstet Gynecol Scand 84(8):767–772
Nilsson CG, Palva K et al (2008) Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19(8):1043–1047
Rinne K, Laurikainen E et al (2008) A randomized trial comparing TVT with TVT-O: 12-month results. Int Urogynecol J Pelvic Floor Dysfunct 19(8):1049–1054
Liapis A, Bakas P et al (2002) Burch colposuspension and tension-free vaginal tape in the management of stress urinary incontinence in women. Eur Urol 41(4):469–473
Latthe PM (2008) Review of transobturator and retropubic tape procedures for stress urinary incontinence. Curr Opin Obstet Gynecol 20(4):331–336
Kitchener HC, Dunn G et al (2006) Laparoscopic versus open colposuspension–results of a prospective randomised controlled trial. BJOG 113(9):1007–1013
Ankardal M, Ekerydh A et al (2004) A randomised trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence. BJOG 111(9):974–981
McCulloch P, Taylor I et al (2002) Randomised trials in surgery: problems and possible solutions. BMJ 324(7351):1448–1451
Maher C, Schuessler B (2006) The need for randomised controlled trials in urogynaecology. Int Urogynecol J Pelvic Floor Dysfunct 17(4):312–314
Price N, Jackson SR (2009) Advances in laparoscopic techniques in pelvic reconstructive surgery for prolapse and incontinence. Maturitas 62(3):276–280
Valpas A et al (2004) Tension-free vaginal tape and laparoscopic mesh colposuspension for stress urinary incontinence. Obstet Gynecol 104(1):42–49
el-Toukhy TA, Davies AE (2001) The efficacy of laparoscopic mesh colposuspension: results of a prospective controlled study. BJU Int 88(4):361–366
Burton G (1997) A three year prospective randomised urodynamic study comparing open and laparoscopic colposuspension. Neurourol Urodyn 16(5):353–354
Su TH et al (1997) Prospective comparison of laparoscopic and traditional colposuspensions in the treatment of genuine stress incontinence. Acta Obstet Gynecol Scand 76(6):576–582
Persson J, Wolner-Hanssen P (2000) Laparoscopic Burch colposuspension for stress urinary incontinence: a randomized comparison of one or two sutures on each side of the urethra. Obstet Gynecol 95(1):151–155
Ward KL, Hilton P (2004) A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress 116 incontinence: two-year follow-up. Am J Obstet Gynecol 190(2):324–331
Fatthy H et al (2001) Modified Burch colposuspension: laparoscopy versus laparotomy. J Am Assoc Gynecol Laparoscopists 8(1):99–106
Gamble TL, et al. (2008) Predictors of persistent detrusor overactivity after transvaginal sling procedures. Am J Obstet Gynecol 199(6):696.e1–7
Lee JK et al (2011) Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis. BJOG 118(7):798–805
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Köktürk, B., Uhl, B. & Naumann, G. Evaluation of indication-specific genuine stress urinary incontinence procedures in a pelvic floor center. Arch Gynecol Obstet 291, 855–863 (2015). https://doi.org/10.1007/s00404-014-3472-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-014-3472-5