Laparoscopic Burch colposuspension.

摘要

PURPOSE OF REVIEW: This review will describe the recent literature regarding laparoscopic Burch colposuspension. RECENT FINDINGS: A 2006 Cochrane review found laparoscopic Burch colposuspension to be equivalent to open Burch colposuspension regarding subjective cure rate, but a reduced objective cure rate was reported. Three subsequent randomized trials have not identified any significant difference between the two procedures with respect to subjective or objective cure rates. Three additional prospective cohorts found cure rates of 76-95%. Another randomized controlled trial found laparoscopic Burch colposuspension with mesh and staples to be inferior to using sutures. There have been no new trials comparing laparoscopic Burch colposuspension and tension-free slings since the Cochrane review. SUMMARY: Laparoscopic Burch colposuspension is an effective treatment for stress urinary incontinence and is equivalent to open Burch colposuspension. Success is affected by the surgeon's experience and surgical technique. No difference in subjective cure rates has been identified in comparison with tension-free slings; however, objective cure rates favor tension-free slings. We believe that laparoscopic Burch colposuspension is the procedure of choice in women undergoing pelvic-floor repair and concomitant retropubic surgery, and in young women, because it avoids the potential complications of mesh. More research comparing the two procedures is indicated.