Laparoscopic Burch Colposuspension versus Transobturator Tape for Female Genuine Stress Urinary Incontinence

Document Type : Original Article

Authors

1 Department of Urology, Damietta Faculty of Medicine, Al-Azhar University, Egypt

2 Department of Urology, Faculty of Medicine [For Girls], Al-Azhar University, Egypt

Abstract

Background: Stress urinary incontinence [SUI] is defined as the involuntary passage of urine during activities lead to increased intra-abdominal pressure. The cause is urethral hypermobility or weakness of intrinsic sphincter. It is a common type of urinary incontinence. No consensus was reached for the standard treatment approach.
Aim of the work: The current study aimed to compare the efficacy and safety of laparoscopic [Burch] colposuspension procedure and Transobturator tape [TOT] procedure in the treatment of female genuine SUI.
Patients and Methods: The study included 30 adult females with grade II or III genuine SUI; according to Blavias and Olsson classification. All were assessed by history taking, physical examination, laboratory and radiological investigations. Then, they were divided into two equal groups according to surgical intervention. the primary outcome was symptoms improvement. Secondary outcomes included intra operative and post-operative complications.
Results: The mean operative time in Burch group was longer than TOT group [70.67 ± 17.48 vs 50.35 ± 25.54, minutes respectively]. However, the difference was non-significant.  The intraoperative blood loss was 90.48 ± 31.55 and 64.57 ± 16.22 ml, in Burch and TOT groups respectively. The type of continence was mainly of sole stress type [86.7% and 93.3% in Burch and TOT groups respectively]. Severe postoperative [PO] pain was reported only by one patient in Burch group. Burch had a significantly lower cost that TOT [155.8 ± 1.46 vs 344.39 ± 1.29 $, respectively], and there was significant reduction of retention, difficulty, dribbling of urine, intermittency and hesitancy [continence status] among Burch than TOT group. In addition, different unwanted aspects of sexual function were significantly lower among Burch than TOT group.
Conclusion: Laparoscopic Burch colposuspension procedure resulted in significantly favorable outcome regarding cost, continence and sexual function. The complications were comparable between both procedures.

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