Frequency of Lower Urinary Tract Injury at Laparoscopic Burch and Paravaginal Repair

Abstract

Study Objective To estimate the rate of injury to the lower urinary tract during laparoscopic Burch urethropexy and/or paravaginal repair. Design Retrospective analysis over 30 consecutive months (Canadian Task Force classification II-2). Setting Community hospital. Patients One hundred seventy-one consecutive patients. Intervention Laparoscopic Burch urethropexy and/or paravaginal repair. Measurements and Main Results All patients had intraoperative transurethral videocystoscopy performed with intravenous injection of indigo carmine dye to assess potential injury to bladder or ureter. Four women (2.3%, CI -0.71–0.03) had injury to the lower urinary tract. All four injuries were cystotomies, two in women with previous open retropubic urethropexy. No ureteral ligation or intravesical placement of suture was diagnosed. Conclusion Despite most patients having both Burch urethropexy and paravaginal repair, the lower urinary tract injury rate of 2.3% is much lower than the reported 10% for patients having Burch urethropexy alone performed by laparotomy. Reported benefits of laparoscopy including less blood loss and better visualization may explain this result.