Modified Burch colposuspension: laparoscopy versus laparotomy.

STUDY OBJECTIVE: To compare results of laparoscopic Burch colposuspension with those of classic Burch colposuspension, and to assess complications, results, and morbidity associated with each procedure.

DESIGN: Prospective, randomized study (Canadian Task Force classification I).

SETTING: Minimal access surgery unit.

PATIENTS: Seventy-four women with genuine stress incontinence.

INTERVENTION: Laparoscopic and classic Burch colposuspensions. MEASUREMENTS AND MEAN RESULTS: Mean operating times for laparoscopic and open surgery were 70.18 +/- 16.54 and 53+/- 10.05 minutes, respectively (p <0.001). Mean blood loss was 42.75 +/- 7.2 and 240.5 +/- 35.5 ml, respectively (p <0.001). Postoperative analgesia requirement was significantly less with laparoscopy (p <0.001). Mean postoperative hospital stay was 36 +/- 6.3 hours for the laparoscopic group and 76+/- 10.4 hours for the open group p<0.001). Average time to return to light work was 8.5 and 31.5 days, respectively. Success rates were 90.9% at 6 months and 87.9% at 18 months in the laparoscopic group, compared with 90% and 85%, respectively, in the open group.

CONCLUSION: Given equal efficacy of the two procedures, we prefer the laparoscopic approach since it is associated with lower morbidity, shorter hospital stay, and fewer complications. (J Am Assoc Gynecol Laparosc 8(1):99-106, 2001)