Laparoscopic Burch Colposuspension
Laparoscopic Burch colposuspension is an operation to help elevate the urethro-vesical junction so as to correct
stress urinary incontinence. The paravaginal tissue of the urethro-vesical junction is elevated by fixing it with the
Cooper’s ligament with the help of non-absorbable sutures or mesh. Subjective and objective cure rates are better with the
non-absorbable sutures. Laparoscopy can be done via extra-peritoneal or intra-peritoneal approach; though most of the
surgeons prefer intra-peritoneal approach. Laparoscopic technique is no way inferior to the laparotomy technique; rather it
has the same efficacy like open Burch colposuspension in short, medium & long term results, (level 1 evidence).
Intraoperative cystoscopy is mandatory as it can find out the accidental inclusion of the bladder, which if not detected, can
lead to many urinary problems afterwards. Apart from this bladder injury related urinary complaint, post-operatively some
other urinary complications are also reported e.g. de novo overactive bladder, voiding difficulties etc. though incidences
are less. Pelvic organ prolapse-urinary incontinence sexual function questionnaire (PISQ) found that sexual functions have
been improved after the operation. Due to the advent of tension free vaginal tape (TVT), trans-obturator tape (TOT) and,
mini sling the popularity of Burch colpo suspension has been decreased. But after the FDA warning on uses of mesh,
there is a resurgence of laparoscopic Burch colposuspension.
Keywords: Burch colposuspension, laparoscopy, retropubic urethropexy, stress urinary incontinence, TVT, TOT.
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