LONG-TERM RESULTS OF LAPAROSCOPIC BURCH URETHROPEXY

Study Objective. To evaluate the long-term efficacy of laparoscopic Bu rch urethropexy. Design. Pilot study. Setting. Private practice. Patie nts. Thirty-five consecutive women (average age 45.5 yrs, average pari ty 2.3, average weight 67.7 kg) treated for genuine stress incontinenc e between May 1992 and July 1994. Interventions. Urethropexy was perfo rmed with curved needle suturing in 7 women, straight needle suturing in 5, and Stamey needle suturing in 23. Twenty-five (71.4%) patients h ad concomitant pelvic surgery. Measurements and Main Results. Wilcoxon two-sample, chi(2), and Fisher's exact tests were performed to determ ine which variables were significantly associated with surgical succes s. Average operating time was 190 minutes, hospitalization 24 hours, a nd catheterization 5 days. The cure rate oi stress incontinence was 89 % 3 months and 86% 1 year after surgery. At average follow-up of 34 mo nths, only 68.6% of patients reported complete or almost complete cure , 11.4% were improved, and 20% were complete failures. The only operat ive variable approaching statistical significance for predicting surgi cal success was type oi suture needle (p = 0.07), with the Stamey need le group having the highest cure rate. Women who were cured or almost cured had a significantly shorter follow-up than those who were improv ed or failures (p = 0.001). Conclusion. The success rate of laparoscop ic Burch urethropexy compares with that of open Burch procedure at 1 y ear, but drops considerably thereafter.