[Effects of laparoscopic Burch colposuspension and tension-free vaginal tape in treatment of female stress urinary incontinence: a comparative study].Zhonghua Yi Xue Za Zhi. 2008 Dec 09; 88(45):3192-4.ZY
To evaluate the efficacy and complications of laparoscopic Burch colposuspension and tension-free vaginal tape (TVT) in treatment of female stress urinary incontinence (SUI).
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.
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.
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.