| Prospective trial of gasless laparoscopic Burch colposuspension using conventional surgical instruments. | |
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MedLine Citation:
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PMID: 15200775 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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G Willy Davila; Edward Stanford; Abner Korn |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2004-06-17 Completed Date: 2004-07-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9417443 Medline TA: J Am Assoc Gynecol Laparosc Country: United States |
Other Details:
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Languages: eng Pagination: 197-203 Citation Subset: IM |
Affiliation:
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Cleveland Clinic Florida, Weston, Florida, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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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