Burch Colposuspension for Treatment of Urodynamic Stress Urinary Incontinence; Laparoscopic versus Open Surgical Approach. A Randomized Controlled Trial

Objective: To compare efficacy and complications of open surgical versus laparoscopic Burch colposuspension for treatment of urodynamic stress urinary incontinence and to demonstrate the presumed advantages of laparoscopic approach. Study design: Prospective randomized trial. Methods: One hundred and four patients with urodynamic stress urinary incontinence were randomly divided into two groups; 52 patients in each.GroupA had open surgical Burch colposuspension and group B had laparoscopic Burch colposuspension. Results: There were no significant differences between both groups regarding one hour pad-test and patient satisfaction during follow up at 1, 6 and 12 months. Operative time in group B was significanly higher than group A (94±6.4 and 52.2±4.3 min, respectively). However, group B had lower pain score and shorter hospital stay than group A. There were no significant differences between both groups as regard intra operative and postoperative complications. Conclusion: Laparoscopic Burch colposuspension is a better approach than open surgical Burch in terms of hospital stay, post-operative pain and recovery, but it needs long learning curve and has longer operative time.