Laparoscopic Burch colposuspension: a minimum of 2 years' follow up and comparison with open colposuspension

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Abstract

Objective

To determine whether laparoscopic colposuspension could achieve similar success rates to open colposuspension, with objective follow up at 6 months and subjective review a minimum of 2 years following surgery, and to compare the postoperative morbidity associated with the two types of procedure.

Design

Retrospective review of the first 139 women to undergo laparoscopic colposuspension at St Mary's Hospital and of 52 women who had most recently undergone open colposuspension in the same hospital, for whom there was a 6-month objective follow up.

Setting

St Mary's Hospital, Manchester, UK.

Results

There was no difference between the two groups in the incidence of intraoperative complications. Postoperative morbidity was reduced in the laparoscopic group, as were analgesic requirements, length of catheterization and postoperative stay. At 6 months, cure and improvement rates were similar between the two groups (71 and 91% with laparoscopic colposuspension vs. 67 and 89% with open colposuspension). At follow up at a minimum of 2 years, both groups had shown a decline in efficacy, but again with no significant difference between the two groups (cure rate 57.8% for the laparoscopic procedure vs. 50.0% for the open one; improvement 77.1% for the laparoscopic vs. 58.7% for the open procedure. Women who had undergone laparoscopic colposuspension returned to normal activities significantly faster and were more likely to be satisfied with the results of surgery than women who had undergone open colposuspension.

Conclusion

At follow up of a minimum of 2 years, laparoscopic colposuspension appeared to have been as effective as open colposuspension in curing stress incontinence. Laparoscopic colposuspension was also associated with reduced postoperative morbidity, shorter hospitalization and earlier return to normal function.

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