2 TECHNIQUES OF LAPAROSCOPIC BURCH-REPAIR FOR STRESS-INCONTINENCE - APROSPECTIVE, RANDOMIZED STUDY

Study Objective. To determine if outpatient laparoscopic Burch procedu re performed with mesh and staples is as effective as that done with t he suture technique. Design. Prospective, randomized study. Setting. C ommunity hospital. Patients. Sixty-nine women with genuine stress inco ntinence (GSI) randomly assigned to either the suture group (group 1) or the mesh-staple group (group 2).Interventions. Before surgery each patient had a complete history, physical and neurologic examinations, 24-hour urolog, urology questionnaire, urine culture and sensitivity, Q-Tip test, transperineal ultrasound, cough stress test, cystourethros copy, and cystometrogram. Stress incontinence was diagnosed by positiv e Q-Tip, ultrasound, and cough stress rests and a negative cystometrog ram for detrusor contraction. The laparoscopic Burch procedures were p erformed with either sutures for bladder neck elevation or with mesh a nd staples. Clinical and, if necessary, urodynamic studies were repeat ed at 6 weeks and 1 year postoperatively. Measurements and Main Result s. The cure rate at 1 year was 91% in group 1 and 94% in group 2. Only objective cures by urologic testing are reported. The hypermobile ure thra, as tested by transperineal ultrasound, was cured by both procedu res. Oi the 69 women, 68 were able to void spontaneously within 24 hou rs. Conclusions. Early results suggest that laparoscopic Burch colposu spension is effective in curing GSI. Both sutures and mesh with staple s yield good outcomes.