Open Burch urethropexy has a low rate of perioperative complications

Our purpose was to report perioperative complication rates with open Burch urethropexy in a tertiary care teaching center.

One hundred fifty-one consecutive hospital and clinic charts of women who underwent Burch urethropexy for genuine stress incontinence between January 1995 and April 2000 were reviewed. Statistical analysis included the chi(2) test of association for nominal data and the Mann-Whitney test for comparison of population medians.

All women had urodynamically proved genuine stress incontinence and 34% had detrusor instability. Most women (81%) had concomitant surgery for pelvic organ prolapse. Sixty-three percent had prior pelvic surgery with 32% having had a urethropexy, needle suspension, or anterior colporrhaphy. Perioperative complications were uncommon. The rate of lower urinary tract injury from Burch urethropexy was <1%. Two cystotomies (1.3%) were associated with surgery for prolapse, and one Burch suture (0.7%) was noted in the bladder on routine intraoperative cystoscopy. One woman (0.7%) received a single unit of blood after surgery, whereas two women had postoperative ileus. Incisional complications were most common (3%) with five cases of cellulitis and one incisional separation. One woman has prolonged voiding dysfunction and continues to perform intermittent self-catheterization 3 years after surgery. Eight percent of women had de novo detrusor instability. No women had perioperative deep venous thromboses, pulmonary emboli, adverse drug reactions, myocardial infarctions, or peripheral nerve injuries. Twenty-nine women (19%) had Burch retropubic urethropexy without concomitant surgery. There were no lower urinary tract injuries, prolonged catheterizations, or development of de novo detrusor instability in this group. The only perioperative complication was a single case of incisional cellulitis (3%).

Open Burch urethropexy has a low rate of perioperative complications. The minimal morbidity of open Burch urethropexy in a teaching setting makes it the preferred teaching technique for this procedure.