AIMS OF STUDY:

To evaluate the results of laparoscopic Burch colposuspension using prolene mesh and taggers for reinforcement.

 

METHODS:

Retrospectively the data concerning the operations of 70 patients treated with laparoscopic colposuspension was collected. All patients were sent a questionnaire to evaluate if they were continent or incontinent and to evaluate the degree of patient satisfaction. Patients not requiring the use of pads were considered continent. Patients with incontinence were examined to evaluate the degree of incontinence.

 

RESULTS:

70 patients had laparoscopic colposuspension between Jan 1996 and Nov 1998. 57 patients had genuine SUI, 13 patients had some detrusor instability together with SUI. 42 patients had transperitoneal Burch and 28 patients had extraperitoneal Burch colposuspension. 39 patients had  colposuspension only, 15 patients had laparoscopic total hysterectomy at the same time and 16 patients had some  minor gynaecological operation at the same time (i.e.ovarian resection, sterilisation, repair of enterocele).

Average age was 48,5 yrs (34-69), average BMI was 26 (18-40). The mean operation time for l-sc colposuspension was 53 min (25-120), av bleeding was 70ml (0-400) in patients who underwent only colposuspension. The average hospital stay was 3.7 days. 7 complications (10%) was recorded; 2 patients had endoscopic repair of bladder perforation (2.9%), 2 bleeding/hematomas in the space of Retzius requiring blood transfusion (2.9%), 3 complications (4.3%) with long lasting urinary retention; 90 days, 105 days and 12 months. One patient was reoperated 8 months after the colposuspension, the mesh and taggers were removed but the retention still carried on for 4 months.

 

QUESTIONNAIRE  AND FOLLOW-UP RESULTS: 

62 of 70 patients had immediate postoperative check-up 6-8

weeks after operation and 61 of  62 were continent. The mean follow-up time is 35 months (17-50 months). 90%

(62 of 70) answered the questionnaire.  36 of 62 (58%) were continent, 26 of 62 (42%) were incontinent  (18% using pads all the time , 24% occasionally). 38 of 62 (61%) were fully satisfied with the operation, 21 of 62 (34%) were partly satisfied, 3 of 62 (5%) were not happy with the result of the operation.

 

CONCLUSION:

The data on laparoscopic Burch procedures is currently limited. The long term results of

laparoscopic Burch colposuspension may not be very encouraging.