Skip to main content
SpringerLink
Log in

Laparoscopic burch repair compared to laparotomy Burch for cure of urinary stress incontinence

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Sixty-two women underwent either laparoscopic Burch urethropexy or open Burch urethropexy for surgical correction of genuine stress urinary incontinence. Only patients with no prior incontinence surgery and with demonstrated genuine stress incontinence were included. Clinical evaluations were done preoperatively, at 3 months and 1 year postoperatively for objective cure. The preoperative evaluation included a 24-hour urolog, urology questionnaire, Q-tip test, cough stress test, perineal ultrasound, cystourethroscopy and simple-channel cystometrics. At follow-up all patients had repeat Q-tip test, perineal ultrasound and cough stress test. If there was any sign of leaking a repeat single-channel cystometrogram was done. Only patients with a negative objective study were considered cured. Differences in laparoscopic versus laparotomy cure rates at 1 year were insignificant (94% versus 93%). Both procedures stabilized the urethrovesical junction and prevented its descent during straining, as demonstrated by the postoperative Q-tip test and the perineal ultrasound. The two bladder procedures had comparable operative times but patients with laparoscopy voided earlier, were outpatients, and returned to work earlier. In conclusion, short-term results suggest that the laparoscopic Burch urethropexy can give similar results to laparotomy Burch urethropexy for correction of genuine stress incontinence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kelly HA, Incontinence of urine in women.Urol Cutan Rev 1913;17:291–329

    Google Scholar 

  2. Stanton SL. Surgery for urinary incontinence.Clin Obstet Gynecol 1978;5:83–108

    Google Scholar 

  3. Park GS, Miller, EJ. Surgical treatment of stress urinary incontinence: a comparison of the Kely plication, Marshall-Marchetti-Krantz, and Pereyra procedures.Obstet Gynecol 1988;71:575–579

    PubMed  Google Scholar 

  4. Bergman A, Ballard CA, Koonings P. Comparison of three different surgical procedures for genuine stress incontinence: prospective randomized study.Am J Obstet Gynecol 1989; 160:1102–1106

    PubMed  Google Scholar 

  5. Bhatia NN, Bergman A. Modified Burch versus Peryera retropubic urethropexy for stress urinary incontinence.Obstet Gynecol 1985;66:255–261

    PubMed  Google Scholar 

  6. Liu CY, Paek W. Laparoscopic retropubic colposuspension (Burch procedure).J am Assoc Gynecol Laparosc 1993;1:31–35

    PubMed  Google Scholar 

  7. Karram MM, Bhatia NN. The Q-tip test: standardization of the technique and its interpretation in women with urinary incontinence.Obstet Gynecol 1988;71:807–811

    PubMed  Google Scholar 

  8. Ross JW. Transperineal ultrasound measurement of urethrovesical descent in genuine stress incontinence.J Ultrasound Med 1995;14:72

    Google Scholar 

  9. Tanagho EA. Colpocystourethropexy: the way we do it.J Urol 1976;116:751–753

    PubMed  Google Scholar 

  10. Abrams P, Blaivas JG, Stanton SL, Andersen JT. The standardization of terminology of lower urinary tract function.Int Urogynecol J 1990;1:45–58

    Google Scholar 

  11. Cardozo LD, Stanton SL, Williams JE. Detrustor instability following surgery for genuine stress incontinence.Br J Urol 1979;51:204–207

    PubMed  Google Scholar 

  12. Sand PK, Bowen LW, Ostergard DR, Brubaker L, Panganibun R. The effect of retropubic urethropexy on detrusor stability.Obstet Gynecol 1988;71:818–827

    PubMed  Google Scholar 

  13. Bump RC, Fantl A, Hurt G. Dynamic urethral pressure profilometry pressure transmission ratio determinations after continence surgery: understanding the mechanism of success, failure, and complications.Obstet Gynecol 1988;72:870–874

    PubMed  Google Scholar 

  14. Lose G, Jorgensen L, Mortensen SO, Molsted-Pedersen L, Kristensen K, Voiding difficulties after colposuspension.Obstet Gynecol 1987;69:33–38

    PubMed  Google Scholar 

  15. Gillon G, Stanton SL. Long term follow-up surgery for urinary incontinence in elderly women.Br J Urol 1984;56:478–481

    PubMed  Google Scholar 

  16. Erikson BC, Hagen B, Eik-Nes SH, Moine K, Mjoinerod OK, Romsio I. Long term effectiveness of the Burch colposuspension in female urinary stress incontinence.Acta Obstet Gynecol Scand 1990;69:45–50

    PubMed  Google Scholar 

  17. Kohorn EI, Scioscia AL, Jeanty P, Hobbins JC. Ultrasound cystourethrography by perineal scanning for the assessment of female stress urinary incontinence.Obstet Gynecol 1986;68:269–272

    PubMed  Google Scholar 

  18. Gordon D, Pearce M, Norton P, Stanton SL. Comparison of ultrasound and lateral chain urethroscopy in the determination of bladder descent.Obstet Gynecol 1989;160:182–185

    Google Scholar 

  19. Wimja J, Tinga DJ, Visser GA. Perineal ultrasonography in women with stress incontinence and controls: the role of the pelvic floor muscles.Gynecol Obstet Invest 1991;32:176–179

    PubMed  Google Scholar 

  20. Bergman A, McKenzie J, Richmond J, Ballard CA, Platt LD. Transrectal ultrasound versus cystography in the evaluation of anatomical stress urinary incontinence.Br J Urol 1988;62:228–234

    PubMed  Google Scholar 

  21. Chang HC, Chang SC, Kuo HC, Tsai TC. Transrectal sonographic cystourethrography: studies in stress urinary incontinence.Urology 1990;36:488–492

    PubMed  Google Scholar 

  22. Weill EA, van Waalwiji van Doorn ES, Heesakers JP, Meguid T, Janknegt RA. Transvaginal ultrasonography: a study with healthy volunteers and women with genuine stress incontinence.Eur Urol 1993;24:226–230

    PubMed  Google Scholar 

  23. Sanders R, Genadry R, Yang A, Mostwin J. Imaging in the female urethra with ultrasound.Ultrasound 1994;12:267–283

    Google Scholar 

  24. Versi E. The significance of an open bladder neck in women.Br J Urol 1991;68:42–43

    PubMed  Google Scholar 

  25. Karram MM. Laparoscopic colposuspension operation: con. Journal of Gynecologic Surgery, 1995;10:205–206

    Google Scholar 

  26. Bhatia NN, Ostergard DR. Urodynamics in women with stress urinary incontinence.Obstet Gynecol 1982;60:552–559

    PubMed  Google Scholar 

  27. Hilton P, Stanton SL. A clinical and urodynamic assessment of the Burch colposuspension for genuine stress incontinence.Br J Obstet Gynaecol 1983;90:934–939

    PubMed  Google Scholar 

  28. Hertogs K, Stanton SL. Mechanism of urinary incontinence after colposuspension: barrier studies.Br J Obstet Gynaecol 1985;92:1184–1188

    PubMed  Google Scholar 

  29. Bump RC, Fantl JA, Hurt WG. Dynamic urethral pressure profilometry pressure transmission ratio determinations after continence surgery: understanding the mechanism of success, failure, complications.Obstet Gynecol 1988;72:870–874

    PubMed  Google Scholar 

  30. Bergman A, Elia G. Three surgical procedures for genuine stress incontinence: five year follow-up of a prospective randomized study.Am J Obstet Gynecol 1995;173:66–71

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Reproductive Medicine and Laparoscopic Surgery, Salinas, California, USA

    J. W. Ross

Authors
  1. J. W. Ross
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Editorial Comment: This is one of the more complete comparative studies of the laparoscopic and open Burch procedures. Although the study is not prospectively randomized, nor were sophisticated urodynamic studies done in all patients, it contains valuable pre- and postoperative information, particularly about the correction of urethrovesical junction mobility as measured by perineal ultrasound. This test demonstrated that both procedures are equally successful in stabilizing the urethrovesical junction. Unfortunately, the cure of stress incontinence was based on stress test alone, with only 4 patients having a CMG postoperatively. By that standard the cure rates of both procedures do not differ. However, we should be cautious in recommending the laparoscopic procedures of research protocols until a prospective randomized comparison utilizing objective urodynamic studies is available. The American Urogynecologic Society has such a multicenter study under way, and we await the results.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ross, J.W. Laparoscopic burch repair compared to laparotomy Burch for cure of urinary stress incontinence. Int Urogynecol J 6, 323–328 (1995). https://doi.org/10.1007/BF01892736

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01892736

Key words

Search

Navigation