Document Detail


Prospective trial of gasless laparoscopic Burch colposuspension using conventional surgical instruments.
MedLine Citation:
PMID:  15200775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To prospectively evaluate the use of gasless laparoscopy techniques in the performance of a traditional Burch colposuspension in women with urodynamically-demonstrated genuine stress incontinence and urethral hypermobility. DESIGN: Multicenter, prospective, single-intervention series (Canadian Task Force Classification II-2). SETTING: Three urogynecologic referral centers. PATIENTS: Fifty-eight women. INTERVENTION: Traditional Burch colposuspension performed utilizing gasless laparoscopic access and conventional surgical instruments. MEASUREMENTS AND MAIN RESULTS: Follow-up was 12 to 38 months. On pad testing, urine loss was significantly reduced, from 6.0 g (CI: 0.55-11.45) to 0.3 g (CI: 0-1.53). Average daily incontinence episodes based on 7-day voiding diaries decreased from 4.7 (CI: 0.87-8.53) to 0.3 (CI: 0-1.58). Q-tip angles were normalized: 49.8 degrees (CI: 40.86-58.74) to 10 degrees (CI: 1.49-18.51). Ninety-five percent of subjects reported resolution of stress incontinence. Three subjects (5%) reported recurrent/persistent genuine stress incontinence: one was operated on during the postpartum period while breastfeeding, and two developed intrinsic sphincteric deficiency postoperatively. Fifty-five percent of subjects underwent other pelvic reconstructive surgery including posterior wall repairs. Average operative time was 60.8 minutes (range, 40-92). The ideal candidate has an unscarred abdominal wall. CONCLUSION: Gasless laparoscopic access was used to effectively perform traditional Burch colposuspension using conventional open surgical instruments. Bladder neck hypermobility was normalized in all subjects, and 95% of subjects reported no further stress incontinence.
Authors:
G Willy Davila; Edward Stanford; Abner Korn
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of the American Association of Gynecologic Laparoscopists     Volume:  11     ISSN:  1074-3804     ISO Abbreviation:  J Am Assoc Gynecol Laparosc     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-06-17     Completed Date:  2004-07-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9417443     Medline TA:  J Am Assoc Gynecol Laparosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-203     Citation Subset:  IM    
Affiliation:
Cleveland Clinic Florida, Weston, Florida, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Equipment Design
Equipment Safety
Female
Follow-Up Studies
Humans
Laparoscopy / methods*
Middle Aged
Patient Satisfaction
Pneumoperitoneum, Artificial
Prospective Studies
Severity of Illness Index
Surgical Instruments*
Surgical Mesh
Treatment Outcome
Urinary Incontinence, Stress / diagnosis,  surgery*
Urodynamics
Urologic Surgical Procedures / instrumentation*,  methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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