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February 2003 · Vol. 15, No. 2

SURGICAL TECHNIQUES

Laparoscopic Burch colposuspension for stress urinary incontinence: When, how, and why?

Female SUI is a common condition without a clear-cut surgical solution. Here, the authors offer step-by-step guidance on a laparoscopic technique to effectively treat this growing problem.


VINCENT  R.  LUCENTE,  MD, MBA; MILES  MURPHY,  MD

Dr. Lucente is medical director of the Institute for Female Pelvic Medicine and Reconstructive Surgery in Allentown, Pa, and associate professor of clinical OBG, Pennsylvania State University College of Medicine, Hershey, Pa. Dr. Murphy is clinical instructor in the division of female pelvic medicine and reconstructive surgery, University of Louisville, Louisville, Ky.

KEY POINTS

  • Laparoscopic Burch colposuspension provides high long-term success rates, reduced morbidity, and accelerated convalescence.

  • A growing number of studies have shown the laparoscopic Burch to have results similar to traditional laparotomy when conventional surgical techniques and suture materials are used.

  • When we limit the discussion to 2 comparable techniques—a laparoscopic versus open 2-suture procedure—there is moderately strong evidence that the laparoscopic approach maintains efficacy while modestly reducing morbidity.

  • The selection of suture material and the total number and placement of sutures are crucial to the long-term cure rate.

Despite the growing body of medical knowledge on stress urinary incontinence (SUI), controversies over its management remain.

SUI is the most common type of inconti-nence and occurs almost exclusively in females. A recent survey by the National Association for Continence revealed that SUI affects approximately 16.5 million women in the United States.1 Nearly two thirds of these women are under 50 years of age.

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