Comparison of the biomechanical properties of vaginal fixation in bladder neck suspensions according to the Burch technique and a percutaneous technique.

Bladder neck suspension or colposuspension can be performed via retropubic or percutaneous transvaginal approaches. A higher success rate is observed for retropubic procedures. One of the hypotheses proposed, but not yet veri fied, is that the retropubic approach allows better quality vaginal fixatio n than the percutaneous approach. Objective : The objective of this study was to compare the biomechanical pr operties of vaginal fixation according to the Burch procedure and according to a percutaneous technique (Vesica(R); Boston Scientific). Material and Methods : We performed bladder neck suspension according to th e Burch technique (2 points) on the left and according to the Vesica(R) per cutaneous technique on the right, on 6 fresh cadavres (mean age 8-5 years), using the same suture material. Vaginal fixations were subsquently excised The depth of penetration into the vagina was measured and a computerized t raction test (Lloyd Instruments, France) was performed on these fixations. The maximum force of traction before rupture was measured. Results : Na significant difference was demonstrated for any of the measure ments. Conclusion : Vaginal fixation of bladder neck suspension performed accordin g to the Burch technique or via a percutaneous technique (Vesica(R)) presen t equivalent biomechanical properties.