describe a new method using a laparoscopic-assisted extraperitoneal route, to modify the
Materials and Methods: Between January 1997 and February 1998, 8 patients
with genuine urinary stress incontinence underwent a laparoscopic-assisted extraperitoneal
Burch procedure. In our approach the bladder is mobilized, and the Coopers ligament
is dissected exclusively by the optica. This technique uses a single extraperitoneal
laparoscopic puncture site with no vaginal or abdominal fascial incision. Two sutures are
done on each side.
Results: This procedure was tolerated well by all of the patients. The
average operative time was 110 minutes (range 95 to 120). Follow up ranged from 8 to 23
months, average 17 months. Seven patients are currently voiding well with no evidence of
incontinence. A single patient reports mild, but improved, stress incontinence.
Conclusions: We find that a laparoscopic-assisted extraperitoneal
modified Burch procedure is a simple, reliable, cost effective, and an easily learned
alternative when compared to other forms of vesicourethropexy. Short-term follow-up of
these patients shows that this procedure has a success rate, which is comparable to that
of other procedures for stress urinary incontinence.
Key words: Laparoscopic, extraperitoneal, stress urinary incontinence