Laparoscopic colposuspension

Laparoscopic Burch colposuspension has entered the surgical armory for the treatment of genuine stress incontinence. The limited data available of the outcomes of the procedure currently suggest that success rates are lower than for the open colposuspension in the short term. Data is lacking on long-term effectiveness. This and the longer operating times documented may reflect inexperience of surgeons. There seem to be advantages in terms of sooner return to normal voiding, earlier discharge from hospital, perioperative morbidity, and a lower incidence of voiding problems when compared with the open procedure. No reduction in the incidence of de novo detrusor instability postoperatively has emerged. A large randomized controlled trial of the two procedures is required to provide higher quality data on outcomes.