Laparoscopic Burch colposuspension for recurrent stress urinary incontinence.

Study Objective: To evaluate the effectiveness of laparoscopic Burch colposuspension in the treatment of recurrent stress urinary incontinence in women with previous vaginal or abdominal retropubic continence surgery.
Design: Retrospective analysis over 36 months (Canadian Task Force classification III).
Setting: Community hospital.
Patients: Thirty-three consecutive patients.
Intervention: Laparoscopic Burch colposuspension.
Measurements and Main Results: Data were obtained by retrospective chart review, telephone interviews, and follow-up physical examinations. Of the 33 patients, 17 (52%) had undergone open retropubic procedures (Burch or Marshall-Marchetti-Krantz), 11 (33%) had had vaginal retropubic needle suspension, and 5 (15%) pubovaginal sling operation. Additional laparoscopic and/or vaginal reconstructive surgery was completed in 32 women (97%) at time of laparoscopic Burch. Average overall operating time was 165 minutes (range 60-287 min), mean estimated blood loss was 178 ml (range 50-600 ml), and hospital stay was 1.1 days. Three intraoperative complications occurred, two cystotomies and one serosal bowel injury. Postoperative objective evaluation over average follow-up of 18.6 months revealed a 90% stress urinary incontinence cure rate.
Conclusion: Laparoscopic Burch colposuspension is safe and effective treatment of recurrent stress urinary incontinence in women who have undergone previous procedures for retropubic continence.