[Effects of laparoscopic Burch colposuspension and tension-free vaginal tape in treatment of female stress urinary incontinence: a comparative study]

Abstract

Objective: To evaluate the efficacy and complications of laparoscopic Burch colposuspension and tension-free vaginal tape (TVT) in treatment of female stress urinary incontinence (SUI).

Methods: Thirty patients underwent laparoscopic Burch colposuspension and 67 age, BMI, parity, and grading-matched patients underwent TVT because of moderate to severe hypermotility urodynamic SUI from 2002 to 2006. Follow-up was conducted for (9 +/- 10) months. The clinical characteristics, mean operation time, hospital stay, peri-operative complications, and late complications were compared.

Results: The mean operative time and the hospital stay of the TVT group was (29.57 +/- 8.23) min and (3.0 +/- 2.1) d, both significantly shorter than those of the Burch operation group [(87 +/- 23) min and (4.8 +/- 1.9) d respectively, P < 0.001 and P < 0.01]. The blood loss of the TVT group was (27 +/- 12) ml, significantly less than that of the Burch operation group [(59 +/- 30) ml, P < 0.001]. The subjective cure rate of the Burch operation group was 86.5%, not significantly different from that of the TVT group (95.5%, P > 0.05). Short-term complications included 1 case of bladder injury and 1 case of circumflex iliac vein injuring, both occurring in the Burch colposuspension group. The postoperative urine retention rate of the Burch colposuspension group was 23.5%, not significantly different from that of the TVT group (14.9%, P > 0.05), and the postoperative fever rate of the Burch colposuspension group was 16.2%, significantly higher than that of the TVT group (4.5%, P < 0.05). Three cases of erosion of sling were found in the TVT group as late complications.

Conclusion: Both Burch colposuspension and TVT are effective in the treatment of female SUI. The mean operative time of Burch operation and the hospital stay thereafter are longer; however, the cost of TVT is much higher than that of the Burch operation.