Laparoscopic versus open Burch colposuspension: a randomised controlled trial.

Full Abstract

OBJECTIVE:
To compare perioperative characteristics, short-term, and long-term outcomes for laparoscopic Burch colposuspension (LBC) and open Burch colposuspension (OBC) for the treatment of urinary stress incontinence.

DESIGN:
Randomised surgical trial with single blinding.

SETTING:
Three tertiary level teaching hospitals involving seven surgeons of varying skill levels.

POPULATION:
Two hundred women with urodynamic stress incontinence (USI).

METHODS:
The two groups were treated in identical fashion, except for the laparoscopic or open approach to surgery. Attempts were made to blind the subjects and the observers obtaining outcome data to treatment group. Analyses were adjusted for surgeon experience.

MAIN OUTCOME MEASURES:
Absence of USI 6 months following surgery, postoperative pain, time spent in hospital, and time to return to activities of normal daily living.

RESULTS:
There were no significant differences in objective and subjective measures of cure and in patient satisfaction at 6 months, 24 months, or 3-5 years of follow up between laparoscopic and open colposuspension groups. Laparoscopic colposuspension took longer time to perform (87 versus 42 minutes, P< 0.0001) but was associated with less blood loss (P = 0.03), less pain (P = 0.02), and quicker return to normal activities (P = 0.01).

CONCLUSION:
LBC has significant advantages over traditional OBC, without any apparent compromise in short-term and long-term outcomes.To compare perioperative characteristics, short-term, and long-term outcomes for laparoscopic Burch colposuspension (LBC) and open Burch colposuspension (OBC) for the treatment of urinary stress incontinence. Randomised surgical trial with single blinding. Three tertiary level teaching hospitals involving seven surgeons of varying skill levels. Two hundred women with urodynamic stress incontinence (USI). The two groups were treated in identical fashion, except for the laparoscopic or open approach to surgery. Attempts were made to blind the subjects and the observers obtaining outcome data to treatment group. Analyses were adjusted for surgeon experience. Absence of USI 6 months following surgery, postoperative pain, time spent in hospital, and time to return to activities of normal daily living. There were no significant differences in objective and subjective measures of cure and in patient satisfaction at 6 months, 24 months, or 3-5 years of follow up between laparoscopic and open colposuspension groups. Laparoscopic colposuspension took longer time to perform (87 versus 42 minutes, P < 0.0001) but was associated with less blood loss (P= 0.03), less pain (P= 0.02), and quicker return to normal activities (P= 0.01). LBC has significant advantages over traditional OBC, without any apparent compromise in short-term and long-term outcomes.

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Author information

Author/s: Carey, M P (MP); Goh, J T (JT); Rosamilia, A (A); Cornish, A (A); Gordon, I (I); Hawthorne, G (G); Maher, C F (CF); Dwyer, P L (PL); Moran, P (P); Gilmour, D T (DT);

Affiliation: Department of Urogynaecology at Royal Women's Hospital, Melbourne, Australia. mcarey(-atsign-)netlink.com.au

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: BJOG : an international journal of obstetrics and gynaecology (BJOG), published in England. (Language: eng)

Reference: 2006-Sep; vol 113 (issue 9) : pp 999-1006

Dates: Created 2006/09/07; Completed 2006/10/24; Revised 2006/11/15;

PMID: 16956331, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: BJOG. 2006 Sep;113(9):985-7. (PMID: 16956328)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Female
Humans
Intraoperative Care
Laparoscopy - methods
Middle Aged

Patient Satisfaction
Pregnancy
Treatment Outcome
Urinary Incontinence, Stress - surgery
Vagina - surgery

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