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[Laparoscopic retropubic colposuspension (Burch procedure). Techniques and continence results]
M Doret1, F Golfier, D Raudrant
1Service de Gynécologie Obstétrique, Hôtel-Dieu, 69002 Lyon.
Introduction:
Laparoscopy allows to perform Burch colposuspension in case of genuine urinary stress incontinence but this approach must not lead to reduced success rates.
Objective:
The aim of this study was to describe laparoscopic Burch techniques and evaluate urinary continence and satisfaction rates.
Materials And Methods:
Clinical and urodynamic data were reviewed for 48 consecutive patients operated on from May 1993 to June 1999. The methods for entering the space of Retzius and performing the colposuspension were analyzed. The continence and satisfaction rates were evaluated with a questionnaire.
Results:
The operative technique we are now using is the extraperitoneal approach with an umbilical trocar site. A non-absorbable mesh is fixed to the Cooper's ligament and to the vaginal fascia. With a mean follow-up of 41 months, the satisfaction rate is 76.8% with a cure rate of 37.3% and an improvement rate of 41.8%.
Conclusion:
Long term results with laparoscopic Burch colposuspension are relatively good but a bit lower than those published with traditional open technique. The effects of the learning curve with an evolving technique are to be considered when analyzing the results.