Comparison of laparoscopic versus open Burch colposuspension techniques for female stress or mixed urinary incontinence: a ten-year experience in a tertiary center

Year 2023, Volume: 4 Issue: 3, 189 - 195, 28.06.2023

Ömer Ünal , Ozan Karadeniz

https://doi.org/10.47582/jompac.1261785

Cited By: 1

Abstract

Aims: To evaluate postoperative course, efficacy, and complication rates of Open Burch Colposuspension and Laparoscopic Burch Colposuspension techniques in stress or mixed urinary incontinence at a single training and research hospital for the last ten years in İstanbul, Turkey.
Methods: A retrospective cohort study was conducted in all Burch Colposuspension cases performed between January 2011 and May 2022 in the Department of Gynecology and Obstetrics of İstanbul Kanuni Sultan Süleyman Training and Resaerch Hospital. All patients’ data were reviewed from the electronic medical records and analyzed who underwent Burch colposuspension surgery either with an open or laparoscopic approach. The primary outcome was a surgical success, whereas secondary outcomes were perioperative and postoperative data, including surgical type, operating time, duration of hospital stay, estimated blood loss, complications, subjective cure, and additional interventional procedure types.
Results: The demographic and clinical characteristics among the groups have no significant difference (p >0.05). The major complication rate postoperatively was considerably higher in the OC group (p<0.004). There is a statistically significant difference in favor of LC in terms of pain score values (VAS) postoperatively at the 6th and 48th hours (6th hour, p=0.036, 48th hour, p<0.0001). There was no statistically significant difference between study groups regarding objective success (%15,5 and %16,9, respectively). Postoperatively, there was no statistically significant difference between groups regarding subjective cure rates (UDI-6 and IIQ-7).
Conclusions: Midurethral Sling procedures are the first-line treatment in SUI patients. However, their long-term effectiveness is similar to other SUI treatments and lower complication rates, so surgeons can prefer LC.

Keywords

Burch colposuspension, laparoscopy, urinary incontinence

Supporting Institution

None

Kadınlarda stres veya mikst üriner inkontinans için laparoskopik ve açık Burch kolposüspansiyon tekniklerinin karşılaştırılması: üçüncü basamak bir merkezde on yıllık bir deneyim

Abstract

Absrakt
Amaç: İstanbul, Türkiye'de son on yıldır tek bir eğitim ve araştırma hastanesinde stres veya mikst tip üriner inkontinansta açık Burch Kolposüspansiyon ve laparoskopik Burch kolposüspansiyon tekniklerinin postoperatif seyrini, etkinliklerini ve komplikasyon oranlarını değerlendirmek.
Gereç ve yöntemler: Kanuni Sultan Süleyman Eğitim ve Araştırma Merkezi'nde Ocak 2011 ile Mayıs 2022 tarihleri ​​arasında gerçekleştirilen tüm Burch kolposüspansiyon vakalarında retrospektif bir kohort çalışması yapıldı. Tüm hastaların verileri hastaların elektronik tıbbi kayıtları incelerek elde edildi ve açık veya laparoskopik Burch kolposüspansiyon ameliyatı geçiren tüm hastalar analiz edildi. Birincil sonuç cerrahi başarı iken, ikincil sonuçlar cerrahi tip, ameliyat süresi, hastanede kalış süresi, tahmini kan kaybı, komplikasyonlar, sübjektif iyileşme ve ek girişimsel prosedür türleri dahil olmak üzere perioperatif ve postoperatif verilerdi.
Bulgular: Gruplar arasında demografik ve klinik özellikler açısından anlamlı fark yoktu (p >0,05) (Tablo 1). Ameliyat sonrası majör komplikasyon oranı OK grubunda oldukça yüksekti (p<0,004) (Tablo 4). Postoperatif 6. ve 48. saatlerde ağrı skoru (VAS) değerleri açısından LK lehine istatistiksel olarak anlamlı fark vardı (6. saat, p=0.036, 48. saat, p<0.0001) (Tablo 3). Objektif başarı açısından çalışma grupları arasında istatistiksel olarak anlamlı fark yoktu (%15,5 ve %16,9, sırasıyla) (Tablo 4). Postoperatif subjektif kür oranları (UDI-6 ve IIQ-7) açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktu (Tablo 3).
Sonuç: Midüretral Askı prosedürleri SÜİ hastalarında birinci basamak tedavidir. Ancak uzun dönem etkinlikleri diğer SÜİ tedavilerine benzer ve komplikasyon oranları daha düşüktür, bu nedenle cerrahlar LC'yi tercih edebilir.

Keywords

burch kolposüspansiyon, laparoskopi, üriner inkontinans

References

• Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017;3:17042. doi:10.1038/nrdp.2017.42
• BURCH JC. Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele, and prolapse. Am J Obstet Gynecol. 1961;81:281-290. doi:10.1016/s0002-9378(16)36367-0
• Lapitan MCM, Cody JD, Mashayekhi A. Open retropubic colposuspension for urinary incontinence in women. Cochrane Database Syst Rev. 2017;7(7):CD002912. doi:10.1002/14651858.CD002912.pub7
• Bezerra CA, Rodrigues AO, Seo AL, Ruano JM, Borrelli M, Wroclawski ER. Laparoscopic Burch surgery: is there any advantage in relation to open approach?. Int Braz J Urol. 2004;30(3):230-236. doi:10.1590/s1677-55382004000300012
• Food, Drug Administration. Department of Health and Human Services (HHS). Obstetrical and gynecological devices; reclassification of surgical instrumentation for use with urogynecological surgical mesh. Final order. Docket No. FDA-2014-N-0297. Federal Register 2018; 82: 1598-603. Available at: https://federalregister.gov/documents/2017/01/06/2016-31862/obstetrical-and-gynecological-devices-reclassification-of surgical-instrumentation-for-use-with.
• Council of the European Union. Position of the Council at first reading with a view to the adoption of a Regulation of the European Parliament and of the Council on medical devices. Brussels, Belgium: European Commission; 2017 March 9. Document reference No: COM(2017)129/F1. 10728/16. Interinstitutional File: 2012/0266 (COD). Available at: ec. Europa. EU/transparency/regdoc/rep/1/2017/EN/COM-2017-129-F1-EN-MAIN-PART-1.PDF Page 117/143 (accessed 25 September 2018).
• Urinary incontinence and pelvic organ prolapse in women: management (NG123). 1.5.2 Surgical management of stress urinary incontinence. p. 25. NICE 2021. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of rights). Last updated 24 June 2019
• Sharma JB, Thariani K, Deoghare M, Kumari R. Autologous fascial slings for surgical management of stress urinary incontinence: a come back. J Obstet Gynaecol India. 2021;71(2):106-114. doi:10.1007/s13224-020-01408-3
• Kavanagh A, Sanaee M, Carlson KV, Bailly GG. Management of patients with stress urinary incontinence after failed midurethral sling. Can Urol Assoc J. 2017;11(6Suppl2):S143-S146. doi:10.5489/cuaj.4610
• Cerniauskiene A, Barisiene M, Jankevicius F, Januska G. Treatment of recurrent stress urinary incontinence in women: comparison of treatment results for different surgical techniques. Wideochir Inne Tech Maloinwazyjne. 2014;9(2):239-245. doi:10.5114/wiitm.2014.43025
• Seckin KD, Kadirogullari P, Kiyak H. Which anti-incontinence surgery option is better in patients undergoing total laparoscopic hysterectomy? burch colposuspension or transobturator tape procedure. Eur J Obstet Gynecol Reprod Biol. 2020;249:59-63. doi:10.1016/j.ejogrb.2020.04.039
• Asıcıoglu O, Gungorduk K, Besımoglu B, et al. A 5-year follow-up study comparing Burch colposuspension and transobturator tape for the surgical treatment of stress urinary incontinence. Int J Gynaecol Obstet. 2014;125(1):73-77. doi:10.1016/j.ijgo.2013.09.026
• Hong JH, Choo MS, Lee KS. Long-term results of laparoscopic Burch colposuspension for stress urinary incontinence in women. J Korean Med Sci. 2009;24(6):1182-1186. doi:10.3346/jkms.2009.24.6.1182
• Köktürk B, Uhl B, Naumann G. Evaluation of indication-specific genuine stress urinary incontinence procedures in a pelvic floor center. Arch Gynecol Obstet. 2015;291(4):855-863. doi:10.1007/s00404-014-3472-5
• Dean N, Ellis G, Herbison GP, Wilson D, Mashayekhi A. Laparoscopic colposuspension for urinary incontinence in women. Cochrane Database Syst Rev. 2017;7(7):CD002239. doi:10.1002/14651858.CD002239.pub3
• Carey MP, Goh JT, Rosamilia A, et al. Laparoscopic versus open Burch colposuspension: a randomised controlled trial. BJOG. 2006;113(9):999-1006. doi:10.1111/j.1471-0528.2006.01037.x
• Kitchener HC, Dunn G, Lawton V, et al. Laparoscopic versus open colposuspension--results of a prospective randomised controlled trial. BJOG. 2006;113(9):1007-1013. doi:10.1111/j.1471-0528.2006.01035.x
• Freites J, Stewart F, Omar MI, Mashayekhi A, Agur WI. Laparoscopic colposuspension for urinary incontinence in women. Cochrane Database Syst Rev. 2019;12(12):CD002239. doi:10.1002/14651858.CD002239.pub4
• Abrar S, Razzak L, Mohsin R. The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country. Pak J Med Sci. 2021;37(5):1359-1364. doi:10.12669/pjms.37.5.4017
• Fusco F, Abdel-Fattah M, Chapple CR, et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. 2017;72(4):567-591. doi:10.1016/j.eururo.2017.04.026
• Oliveira LM, Dias MM, Martins SB, Haddad JM, Girão MJBC, Castro RA. Surgical treatment for stress urinary incontinence in women: a systematic review and meta-analysis. Tratamento cirúrgico da incontinência urinária de esforço em mulheres: revisão sistemática e metanálise. Rev Bras Ginecol Obstet. 2018;40(8):477-490. doi:10.1055/s-0038-1667184
• Veit-Rubin N, Dubuisson J, Ford A, Dubuisson JB, Mourad S, Digesu A. Burch colposuspension. Neurourol Urodyn. 2019;38(2):553-562. doi:10.1002/nau.23905