Purpose: We describe a new method using a laparoscopic-assisted extraperitoneal route, to modify the Burch procedure.
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 Cooper’s 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