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Synthetic retropubic midurethral slings (RMUS) and robotic-assisted Burch urethropexies (RA-Burch) are common surgical treatment options for stress urinary incontinence (SUI). Few data exist comparing the success of these two retropubic surgeries. This retrospective cohort study of RA-Burch and RMUS procedures compared the proportion of patients with subjective cure after RA-Burch compared to RMUS at our institution between 2016 and 2020. Subjective cure was defined as reporting no symptoms of SUI at longest follow-up. Chi-square, Fisher's exact, Mann–Whitney U tests, logistic regression, and Kaplan–Meier log-rank tests were used in analyses. The overall cohort of 235 subjects included 47 RA-Burch cases matched 1:4 with 188 RMUS cases. Patients who underwent RA-Burch were younger (p <.01), had lower BMIs (p =.04), and were more likely to have concomitant procedures, including hysterectomy (p <.01). There was no difference in subjective cure at longest follow-up (p =.76). Median follow-up was longer in the RA-Burch group (p <.01). There was no difference in early postoperative complications, EBL, treatment for persistent SUI, or new urge urinary incontinence at longest follow-up. Both groups experienced postoperative urinary retention at a similar rate, although 4 RMUS patients required sling lysis and one patient experienced a mesh exposure. Patients undergoing RA-Burch had significantly longer OR times when no concomitant procedure was performed (p <.01). There were no significant predictors of SUI recurrence when controlling for baseline variables. This study suggests that RA-Burch and RMUS may be equally efficacious for patients with symptoms of SUI desiring surgical management. [ABSTRACT FROM AUTHOR]

Burch urethropexy is one of the earliest and most effective surgeries for stress urinary incontinence. Minimally invasive robotic surgery is becoming more popular in the field of urogynecology. Herein, we present the safety and efficacy of a large case series of robotic-assisted Burch urethropexy. A retrospective chart review was performed on robotic-assisted Burch urethropexy cases performed between 2013 and 2019. Patient characteristics, perioperative data and follow-up outcomes were collected at a single teaching institution. A total of 76 women underwent robotic-assisted Burch urethropexy for pure stress urinary incontinence. Fifty of them had concomitant robotic procedures at the time of the Burch. We performed the robotic-assisted Burch urethropexy alone on 26 patients. The mean age was 55 years old. The overall treatment success rate was 85% with a mean follow-up time of 134 (±157.8) days. Complications included cystotomy (3%), urinary tract infection (16%) and postoperative voiding dysfunction (10%). Our study reveals that robotic-assisted Burch urethropexy is a feasible option in the treatment of stress urinary incontinence in terms of operative outcomes and short-term efficacy. What is already known on this subject? Minimally invasive robotic surgery is becoming more popular in the field of urogynecology. Surgical repairs for stress urinary incontinence will likely increase in the coming years secondary to an aging population. Burch urethropexy is one of the earliest and most effective surgeries for stress urinary incontinence and can be performed abdominally, laparoscopically and now, using robotic assistance. What do the results of this study add? This study reveals that robotic-assisted Burch urethropexy is a feasible option in the treatment of stress urinary incontinence in terms of intraoperative outcomes with good short-term efficacy. What are the implications of these findings for clinical practice and/or further research? Lately, interest in colposuspension procedures has been rekindled as physicians seek alternative stress urinary incontinence treatment options. Robotic-assisted Burch urethropexy will continue to gain popularity with its efficacy and safety. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the safety and efficacy of a new minimally invasive surgical procedure for the treatment of female stress urinary incontinence (SUI). Four miniature bone anchors, each attached to a suture, are inserted transvaginally into the retropubic bone using an inserter on each side of the urethra without opening the vaginal mucosa. Tying the suture on each ipsilateral side creates colposuspension, as is the aim of previously described procedures such as the Marshall-Marchetti-Krantz. Sixty-one women (mean age 52±SD 9.9 years) with a mean follow-up of more than 12 months (range 12–30 months) were treated for SUI. Fifty patients (82%) are dry, 7 (14%) reported great improvement and 4 are considered surgical failures. The data presented suggest that our new minimally invasive procedure provides an effective treatment for female SUI. Its main advantages over other procedures are the transvaginal approach and short operating time. [ABSTRACT FROM AUTHOR]

Background: For patients with stress urinary incontinence, surgical reestablishment of the bladder neck has proved amenable to a laparoscopic approach, which shortens hospitalization and reduces tissue trauma. The use of mesh reinforcement to improve the durability of colposuspension can refine this proven procedure even further.Methods: We performed laparoscopic Burch colposuspension on 54 patients with stress urinary incontinence and compared our results with those of other investigators.Results: All patients reported resolution of incontinence postoperatively: 83.3% received no supplementary medication while 16.7% took antispasmodic-anticholinergic medications. Two cases required conversion to an open procedure. Hospital stay declined from 2.7 days (first quartile) to 1.9 days (last quartile) (average, 2.3 days). Complications were rare, and in a 28-month follow-up, no reoperations were required.Conclusion: Laparoscopic Burch colposuspension using mesh reinforcement provides durable resolution of stress incontinence with low risk of conversion, short hospitalization, and few complications. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The authors sought to determine whether a vaginal paravaginal defects cystopexy combined with a paraurethral fascial sling urethropexy is an effective surgical procedure in restoring normal anatomic positioning of the anterior pelvic compartment in cases of genitourinary prolapse associated with overt or masked genuine urinary stress incontinence. In this observational study of 75 patients, each underwent repair of all defects of pelvic support accompanied by this combined procedure for anterior compartment restoration. Sixty-one patients (81%) complained primarily of protruding masses; 25 (33%) had had at least one prior attempt at cystocele repair. Follow-up ranging from 6 months to 3 years was obtained in 72 cases. Sixty-eight (94.4%) patients denied postoperative urinary incontinence. Symptoms of genital prolapse were relieved in all but one. The combined paraurethral fascial sling urethropexy and vaginal paravaginal defects cystopexy present a valuable approach in operative repair when multiple pelvic compartments are involved in prolapse. [ABSTRACT FROM AUTHOR]

A 10-month-old, unilateral cryptorchid, male English bulldog underwent urethropexy for the treatment of urethral prolapse. Six hours after surgery the dog developed dysuria, haematuria, discomfort, severe penile oedema, inflammation, and inability to extrude the penis from the prepuce. Urethral patency was restored by placing an indwelling catheter into the urethral lumen. Penile swelling was managed with cold and warm compresses for 2 days, and antibiotics, nonsteroidal anti-inflammatory drugs, and opioids for 4 days. Complete resolution of the swelling was evident by 3 days after surgery. One year after surgery the dog was reported to be in good health. [ABSTRACT FROM AUTHOR]

The Burch colposuspension has a 50-plus year history demonstrating strong long-term outcomes with minimal complications. Iterations of the procedure, including laparoscopic, robotic, and mini-incisional approaches, appear to have equal efficacy to the open procedure. Although the current use of the Burch colposuspension has waned with the growing shift toward sling surgery, it continues to have a role in the treatment of stress urinary incontinence. Specifically, a Burch procedure should be considered when vaginal access is limited, concurrent intra-abdominal surgery is planned, or mesh is contraindicated., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: The objective of the study was to describe long-term objective and subjective success rates and complications following transvaginal Burch urethropexy for stress urinary incontinence. Study design: A case series of 66 women who underwent vaginal Burch urethropexy for urodynamic stress urinary incontinence with urethral hypermobility using a suture carrier device is presented. Concurrent prolapse repairs were performed as indicated. Results: Sixty-six women (mean age 49.4 ± 12.1 years) underwent vaginal Burch urethropexy. Mean follow-up time was 20.9 ± 18.9 months. Objective failure was observed in 16 patients (24.2%). Subjective failure was reported by 21.2% of patients, with 50% and 28.8% reporting success and improvement, respectively. Six patients (9%) experienced febrile illness, 4 (6%) experienced intraoperative hemorrhage, 1 (1.5%) received transfusion, and 1 (1.5%) experienced pelvic abscess. Twelve patients (18.2%) experienced suture erosion; half required surgical revision or excision. Conclusion: Vaginal Burch urethropexy is generally well tolerated but is associated with poor long-term success and high suture erosion rates. [Copyright &y& Elsevier]