The Comparison of Long Term Outcome after Burch and Stamey Operation in Stress Urinary Incontinence Patients / 대한비뇨기과학회지

Burch and Stamey operations are reliable techniques for correcting genuine stress urinary - incontinence. The purpose of this study is to evaluate which operation brings better success and which factors affect the postoperative outcome. We reviewed 103 patients who underwent Burch (53 patients) and Stamey (50 patients) operations between January 1992 and June 1994 for stress urinary incontinence. The followup period of all patients was over 2 years and mean followup was 37 months. A standardized questionnaire using telephone was used to evaluate postoperative outcome. Cure (complete dryness) rate was 72% in Burch and 48% in Stamey group. Overall, a successful outcome (cure or rare stress incontinence not requiring protection) was 92% of patients in Burch and 76% in Stamey group. In Stamey group, the only significant predictor of outcome was the degree of preoperative stress urinary incontinence (mild, moderate, severe) but not in Burch group. No statistical correlation in success was found with patients age, number of parity, prior hysterectomy, combined operation (hysterectomy, anterior and posterior colporraphy), preoperative urgency and urge incontinence. Preoperative urgency was present in 23% of Burch, and 30% of Stamey group patients. Postoperative resolution of urgency was 58% in Burch, and 60% in Stamey group. De novo urgency occurred in 20% of Burch group patients, and in 14% of Stamey group patients. Persistent or de novo urgency was more common among failure group than success group (75% vs 20% in Burch group, 42% vs 16% in Stamey group). The success rate of Burch operation was higher than Stamey operation. So we think Burch operation is better management for stress urinary incontinence. In Stamey group, the only factor affecting on outcome was the degree of preoperative stress urinary incontinence.

Comparison of Extraperitoneal Laparoscopic Burch versus Open Burch and Raz`s Suspension for Female Genuine Stress Urinary Incontinence / 대한비뇨기과학회지

The purpose of this study was to determine the feasibility of treating female stress incontinence with a extraperitoneal laparoscopic Burch. We compared the operative data of laparoscopic Burch, open Burch and Raz`s suspension and we introduced our technique, hybrid of the laparoscopic Burch and Gittes` procedure which avoids traditional intracorporeal suturing entirely. Twenty patients underwent a laparoscopic Burch were compared with 15 open Burch and 21 Raz`s suspension during the same time period for anatomical stress incontinence. We did not use the application of balloon dissection and intracorporeal suturing but extracorporeal knot tying. The results showed that laparoscopic Burch operation could shorten the Foley catheter removal day and hospital day compared to other methods. There were no significant differences in operation time and the complications. Laparoscopic Burch operation offers a less invasive approach to surgical correction of stress urinary incontinence and a rapid return to normal activities. Further clinical assessment is necessary to evaluate the long-term feasibility.