Randomized comparison of laparoscopic and transabdominal burch urethropexy for the treatment of genuine stress incontinence

Abstract

Objective: To compare operative parameters, complications, recovery, success rate, and urodynamic results between laparoscopic and transabdominal Burch urethropexies.Methods: Women with stress incontinence, from five centers, were randomly assigned to a laparoscopic or transabdominal Burch urethropexy. Operative parameters and postoperative recovery were compared. Physical examination and subjective and objective cures were assessed at 3 months and 1 year. Urodynamic studies were also performed at 1 year.Results: Sixty-two subjects completed follow-up (28 laparoscopic and 34 transabdominal Burches). Three laparoscopic procedures were converted to abdominal procedures due to severe intraabdominal adhesions. The laparoscopic Burch had a longer mean operating time (173.2 minutes versus 118.6 minutes, P = 0.0001). The transabdominal Burch had a longer mean hospital stay (2.1 days versus 1.4 days, P = 0.0057). There were no statistical differences between complications, postoperative fever, and mean time to resumption of voiding. Objective surgical success was not different between the laparoscopic and transabdominal Burch groups at 3 months (100% versus 97.06%) and 1 year (92.86% versus 88.24%). No significant differences were noted in urodynamic measures.Conclusions: Although differences exist between the laparoscopic and transabdominal Burch with regard to operating time and hospital stay, both procedures are comparable with regard to surgical success in treating stress incontinence.