Extraperitoneal Laparoscopic Colposuspension

Abstract

In Brief Objective To compare duration of surgery, length of hospital stay, complications, and short-term cure rate of extraperitoneal laparoscopic colposuspension with that of Burch colposuspension. Methods We retrospectively reviewed 157 consecutive cases of extraperitoneal laparoscopic (n = 70) or Burch colposuspension (n = 87) performed between January 1, 1995, and June 30, 1997. Cure rate was assessed by history, physical examination, and questionnaire. Patients not requiring the use of pads were considered continent. Cure rates were compared in the entire group, whereas complications, duration of surgery, and length of stay were compared only in subgroups undergoing colposuspension alone. Results were analyzed statistically. Results The mean times to follow-up were 12.9 months (laparoscopic group) and 16.3 months (Burch group). At last follow-up, 64 of 70 (91.4%) of the laparoscopic and 80 of 87 (92%) of the Burch colposuspension group were continent. In patients who underwent colposuspension alone, results were as follows for those who underwent laparoscopic (19) and Burch (21) procedures, respectively: average duration of surgery, 49.2 compared with 62.6 minutes (P < .03); average hospital stay, 14 hours compared with 2.7 days (P < .001); average postoperative disability period, 1.6 weeks compared with 4.7 weeks (P < .001); incidence of complications, 15.8% compared with 33.3% (P = .170). Conclusion Extraperitoneal laparoscopic colposuspension, compared with Burch colposuspension, resulted in similar short-term cure rates and complications, shorter duration of surgery, hospital stay, and convalescence. It is a feasible option in treatment of stress urinary incontinence when laparotomy is not required. Extraperitoneal laparoscopic colposuspension may be considered an alternative to Burch colposuspension in cases that do not require laparotomy.