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Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized trial.
Obstet Gynecol. 2004 Dec; 104(6):1249-58.OG

Abstract

OBJECTIVE

To compare the laparoscopic Burch colposuspension with the tension-free vaginal tape procedure (TVT) for efficacy.

METHODS

Seventy-two women from 2 institutions were randomized: 36 to laparoscopic Burch colposuspension and 36 to TVT. Multichannel urodynamic tests were performed preoperatively and 1 year after surgery. A research nurse administered the Urogenital Distress Inventory, Incontinence Impact Questionnaire, and pelvic examinations using the pelvic organ prolapse quantification system preoperatively, and at 6 months, 1 year, and 2 years after surgery. Voiding diaries were collected at 1 and 2 years. Primary outcome was objective cure, which was defined as no evidence of urinary leakage during postoperative urodynamic studies. Secondary outcomes included subjective continence, perioperative and postoperative data, and quality of life.

RESULTS

Thirty-three laparoscopic Burch colposuspension and 33 TVT patients were analyzed with a mean follow-up of 20.6 +/- 8 months (range 12-43). Mean operative time was significantly greater in the laparoscopic Burch colposuspension group compared with the TVT group, 132 versus 79 minutes, respectively (P = .003). Multichannel urodynamic studies in 32 laparoscopic Burch colposuspension and 31 TVT patients showed a higher rate of urodynamic stress incontinence at 1 year in the laparoscopic Burch colposuspension group, 18.8% versus 3.2% (P = .056). There was a significant improvement in the number of incontinent episodes per week and in Urogenital Distress Inventory and Incontinence Impact Questionnaire scores in both groups at 1 and 2 years after surgery (P < .001). However, postoperative subjective symptoms of incontinence (stress, urge, and any urinary incontinence) were reported significantly more often in the laparoscopic Burch colposuspension group than in the TVT group (P < .04 for each category).

CONCLUSION

The TVT procedure results in greater objective and subjective cure rates for urodynamic stress incontinence than does laparoscopic Burch colposuspension.

Authors+Show Affiliations

Paraiso MF
Department of Obstetrics and Gynecology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA. paraism@ccf.org
Walters MD
No affiliation info available
Karram MM
No affiliation info available
Barber MD
No affiliation info available

MeSH

AdultAgedFemaleHumansMiddle AgedPatient SatisfactionProspective StudiesProstheses and ImplantsQuality of LifeUrinary Incontinence, StressUrodynamics

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15572485

Citation

Paraiso, Marie Fidela R., et al. "Laparoscopic Burch Colposuspension Versus Tension-free Vaginal Tape: a Randomized Trial." Obstetrics and Gynecology, vol. 104, no. 6, 2004, pp. 1249-58.
Paraiso MF, Walters MD, Karram MM, et al. Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized trial. Obstet Gynecol. 2004;104(6):1249-58.
Paraiso, M. F., Walters, M. D., Karram, M. M., & Barber, M. D. (2004). Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized trial. Obstetrics and Gynecology, 104(6), 1249-58.
Paraiso MF, et al. Laparoscopic Burch Colposuspension Versus Tension-free Vaginal Tape: a Randomized Trial. Obstet Gynecol. 2004;104(6):1249-58. PubMed PMID: 15572485.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized trial. AU - Paraiso,Marie Fidela R, AU - Walters,Mark D, AU - Karram,Mickey M, AU - Barber,Matthew D, PY - 2004/12/2/pubmed PY - 2005/2/3/medline PY - 2004/12/2/entrez SP - 1249 EP - 58 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 104 IS - 6 N2 - OBJECTIVE: To compare the laparoscopic Burch colposuspension with the tension-free vaginal tape procedure (TVT) for efficacy. METHODS: Seventy-two women from 2 institutions were randomized: 36 to laparoscopic Burch colposuspension and 36 to TVT. Multichannel urodynamic tests were performed preoperatively and 1 year after surgery. A research nurse administered the Urogenital Distress Inventory, Incontinence Impact Questionnaire, and pelvic examinations using the pelvic organ prolapse quantification system preoperatively, and at 6 months, 1 year, and 2 years after surgery. Voiding diaries were collected at 1 and 2 years. Primary outcome was objective cure, which was defined as no evidence of urinary leakage during postoperative urodynamic studies. Secondary outcomes included subjective continence, perioperative and postoperative data, and quality of life. RESULTS: Thirty-three laparoscopic Burch colposuspension and 33 TVT patients were analyzed with a mean follow-up of 20.6 +/- 8 months (range 12-43). Mean operative time was significantly greater in the laparoscopic Burch colposuspension group compared with the TVT group, 132 versus 79 minutes, respectively (P = .003). Multichannel urodynamic studies in 32 laparoscopic Burch colposuspension and 31 TVT patients showed a higher rate of urodynamic stress incontinence at 1 year in the laparoscopic Burch colposuspension group, 18.8% versus 3.2% (P = .056). There was a significant improvement in the number of incontinent episodes per week and in Urogenital Distress Inventory and Incontinence Impact Questionnaire scores in both groups at 1 and 2 years after surgery (P < .001). However, postoperative subjective symptoms of incontinence (stress, urge, and any urinary incontinence) were reported significantly more often in the laparoscopic Burch colposuspension group than in the TVT group (P < .04 for each category). CONCLUSION: The TVT procedure results in greater objective and subjective cure rates for urodynamic stress incontinence than does laparoscopic Burch colposuspension. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/15572485/Laparoscopic_Burch_colposuspension_versus_tension_free_vaginal_tape:_a_randomized_trial_ DB - PRIME DP - Unbound Medicine ER -