A surgical technique to adjust bladder neck suspension in laparoscopic Burch colposuspension

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3 Citations (Scopus)

Abstract

Study objective: To evaluate the anatomic and functional efficacy of a surgical technique designed to prevent overcorrection of the bladder neck in laparoscopic Burch colposuspension for primary urodynamic stress incontinence. Design: Prospective, observational study (Canadian Task Force classification II-2). Setting: Medical center, Taipei, Taiwan. Patients: One hundred fifty-five consecutive women, aged 33 to 71 years, undergoing laparoscopic Burch colposuspension for primary (not previously operated on) urodynamic stress incontinence were prospectively assessed over a 6-year period. Interventions: A bladder neck suspension technique, derived from serial perioperative ultrasound examinations for open Burch colposuspension, was incorporated into laparoscopic Burch procedure. Measurements and main results: The outcome measures included duration of postoperative voiding trials, morphologic changes on ultrasound scanning within 1 month of operation, postoperative continence rate, persistent or de novo urge symptoms or detrusor overactivity, and therapeutic satisfaction for laparoscopic Burch colposuspension. At 1-year follow-up, the objective cure rate was 94.8% (110/116), subjective cure rate was 95.7% (111/116), and overall therapeutic satisfaction was 92.2% (107/116). Kaplan-Meier analysis revealed the cumulative rates for subjective cure of stress incontinence and freedom from urge symptoms at 1, 3, and 5 years were 95.7%, 90.7%, and 76.5%, and 92.7%, 90.4%, and 90.4%, respectively. Four women (2.6%) had prolonged voiding trials greater than 1 week. Urge symptoms occurred in 12 women (7.7%), and de novo detrusor overactivity occurred in 6 (3.9%). Demographic factors, concomitant surgical procedures, and perioperative morphologic variables did not correlate with prolonged voiding trials or postoperative urge symptoms. Conclusions: Our standardized surgical technique may help to avoid overelevation and associated postoperative complications without compromising the success of laparoscopic colposuspension for primary urodynamic stress incontinence.

Original languageEnglish
Pages (from-to)289-295
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume13
Issue number4
DOIs
Publication statusPublished - Jul 2006
Externally publishedYes

Fingerprint

Urodynamics
Suspensions
Urinary Bladder
Urge Urinary Incontinence
Kaplan-Meier Estimate
Advisory Committees
Taiwan
Observational Studies
Demography
Outcome Assessment (Health Care)
Prospective Studies
Therapeutics

Keywords

  • De novo detrusor overactivity
  • Laparoscopic Burch colposuspension
  • Voiding dysfunction

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{e8b0d8ebe0df48738c710612277d8229,
title = "A surgical technique to adjust bladder neck suspension in laparoscopic Burch colposuspension",
abstract = "Study objective: To evaluate the anatomic and functional efficacy of a surgical technique designed to prevent overcorrection of the bladder neck in laparoscopic Burch colposuspension for primary urodynamic stress incontinence. Design: Prospective, observational study (Canadian Task Force classification II-2). Setting: Medical center, Taipei, Taiwan. Patients: One hundred fifty-five consecutive women, aged 33 to 71 years, undergoing laparoscopic Burch colposuspension for primary (not previously operated on) urodynamic stress incontinence were prospectively assessed over a 6-year period. Interventions: A bladder neck suspension technique, derived from serial perioperative ultrasound examinations for open Burch colposuspension, was incorporated into laparoscopic Burch procedure. Measurements and main results: The outcome measures included duration of postoperative voiding trials, morphologic changes on ultrasound scanning within 1 month of operation, postoperative continence rate, persistent or de novo urge symptoms or detrusor overactivity, and therapeutic satisfaction for laparoscopic Burch colposuspension. At 1-year follow-up, the objective cure rate was 94.8{\%} (110/116), subjective cure rate was 95.7{\%} (111/116), and overall therapeutic satisfaction was 92.2{\%} (107/116). Kaplan-Meier analysis revealed the cumulative rates for subjective cure of stress incontinence and freedom from urge symptoms at 1, 3, and 5 years were 95.7{\%}, 90.7{\%}, and 76.5{\%}, and 92.7{\%}, 90.4{\%}, and 90.4{\%}, respectively. Four women (2.6{\%}) had prolonged voiding trials greater than 1 week. Urge symptoms occurred in 12 women (7.7{\%}), and de novo detrusor overactivity occurred in 6 (3.9{\%}). Demographic factors, concomitant surgical procedures, and perioperative morphologic variables did not correlate with prolonged voiding trials or postoperative urge symptoms. Conclusions: Our standardized surgical technique may help to avoid overelevation and associated postoperative complications without compromising the success of laparoscopic colposuspension for primary urodynamic stress incontinence.",
keywords = "De novo detrusor overactivity, Laparoscopic Burch colposuspension, Voiding dysfunction",
author = "Yang, {Jenn Ming} and Yang, {Shwu Huey} and Huang, {Wen Chen}",
year = "2006",
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doi = "10.1016/j.jmig.2006.03.019",
language = "English",
volume = "13",
pages = "289--295",
journal = "Journal of Minimally Invasive Gynecology",
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T1 - A surgical technique to adjust bladder neck suspension in laparoscopic Burch colposuspension

AU - Yang, Jenn Ming

AU - Yang, Shwu Huey

AU - Huang, Wen Chen

PY - 2006/7

Y1 - 2006/7

N2 - Study objective: To evaluate the anatomic and functional efficacy of a surgical technique designed to prevent overcorrection of the bladder neck in laparoscopic Burch colposuspension for primary urodynamic stress incontinence. Design: Prospective, observational study (Canadian Task Force classification II-2). Setting: Medical center, Taipei, Taiwan. Patients: One hundred fifty-five consecutive women, aged 33 to 71 years, undergoing laparoscopic Burch colposuspension for primary (not previously operated on) urodynamic stress incontinence were prospectively assessed over a 6-year period. Interventions: A bladder neck suspension technique, derived from serial perioperative ultrasound examinations for open Burch colposuspension, was incorporated into laparoscopic Burch procedure. Measurements and main results: The outcome measures included duration of postoperative voiding trials, morphologic changes on ultrasound scanning within 1 month of operation, postoperative continence rate, persistent or de novo urge symptoms or detrusor overactivity, and therapeutic satisfaction for laparoscopic Burch colposuspension. At 1-year follow-up, the objective cure rate was 94.8% (110/116), subjective cure rate was 95.7% (111/116), and overall therapeutic satisfaction was 92.2% (107/116). Kaplan-Meier analysis revealed the cumulative rates for subjective cure of stress incontinence and freedom from urge symptoms at 1, 3, and 5 years were 95.7%, 90.7%, and 76.5%, and 92.7%, 90.4%, and 90.4%, respectively. Four women (2.6%) had prolonged voiding trials greater than 1 week. Urge symptoms occurred in 12 women (7.7%), and de novo detrusor overactivity occurred in 6 (3.9%). Demographic factors, concomitant surgical procedures, and perioperative morphologic variables did not correlate with prolonged voiding trials or postoperative urge symptoms. Conclusions: Our standardized surgical technique may help to avoid overelevation and associated postoperative complications without compromising the success of laparoscopic colposuspension for primary urodynamic stress incontinence.

AB - Study objective: To evaluate the anatomic and functional efficacy of a surgical technique designed to prevent overcorrection of the bladder neck in laparoscopic Burch colposuspension for primary urodynamic stress incontinence. Design: Prospective, observational study (Canadian Task Force classification II-2). Setting: Medical center, Taipei, Taiwan. Patients: One hundred fifty-five consecutive women, aged 33 to 71 years, undergoing laparoscopic Burch colposuspension for primary (not previously operated on) urodynamic stress incontinence were prospectively assessed over a 6-year period. Interventions: A bladder neck suspension technique, derived from serial perioperative ultrasound examinations for open Burch colposuspension, was incorporated into laparoscopic Burch procedure. Measurements and main results: The outcome measures included duration of postoperative voiding trials, morphologic changes on ultrasound scanning within 1 month of operation, postoperative continence rate, persistent or de novo urge symptoms or detrusor overactivity, and therapeutic satisfaction for laparoscopic Burch colposuspension. At 1-year follow-up, the objective cure rate was 94.8% (110/116), subjective cure rate was 95.7% (111/116), and overall therapeutic satisfaction was 92.2% (107/116). Kaplan-Meier analysis revealed the cumulative rates for subjective cure of stress incontinence and freedom from urge symptoms at 1, 3, and 5 years were 95.7%, 90.7%, and 76.5%, and 92.7%, 90.4%, and 90.4%, respectively. Four women (2.6%) had prolonged voiding trials greater than 1 week. Urge symptoms occurred in 12 women (7.7%), and de novo detrusor overactivity occurred in 6 (3.9%). Demographic factors, concomitant surgical procedures, and perioperative morphologic variables did not correlate with prolonged voiding trials or postoperative urge symptoms. Conclusions: Our standardized surgical technique may help to avoid overelevation and associated postoperative complications without compromising the success of laparoscopic colposuspension for primary urodynamic stress incontinence.

KW - De novo detrusor overactivity

KW - Laparoscopic Burch colposuspension

KW - Voiding dysfunction

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