Laparoscopic Burch Colposuspension with the Choi's Hook / 대한산부인과학회지

OBJECTIVE: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi's hook in laparoscopic Burch operation. METHODS: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament (Group 2). RESULTS: The mean age of patients of Group 1 was 55.6+/-9.37 years of age and that of Group 2 was 56.0+/-5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5+/-15.32 minutes for Group 1 and 38.5+/-10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P0.05). CONCLUSION: We performed laparoscopic Burch operation with the Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi's Hook, we could shorten the operation time using the Choi's Hook.

Comparison of Extraperitoneal Laparoscopic Burch Operation versus Raz Operation for Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: Results of extraperitoneal laparoscopic bladder neck suspension(BNS) and that of Raz procedure for the correction of stress urinary incontinence (SUI) were analyzed retrospectively. MATERIALS AND METHODS: Among 39 patients who underwent laparoscopic BNS for anatomical SUI, 28 patients had follow-up study at postoperative 6 months. All 87 patients who underwent Raz procedure were also followed up at postoperative 6 months. RESULTS: Mean operation time in laparoscopic BNS was 138 min initially but, was shortened to 95 min. after using 'thick (5 mm) knot pusher'; whereas mean operation time in Raz group was 56min. Return to normal voiding and mean duration of hospital stay were possible in 1.2 days and 2.6 days in laparoscopic group and 11.9 days and 4.5 days in Raz group with significant difference between 2 groups. Amount of residual urine at discharge was less than 100cc In all except 1 case in laparoscopic group(27/28, 96%). However in Raz group, 35 patient(40%) still showed residual urine of more than 1 00ml at the time of discharge. Postoperatively, voiding difficulty was noted in 3, frequency in 15, bleeding in 2, dyspareunia and bladder stone in 1 case for Raz group; In laparoscopic group, frequency was noted in 3, voiding difficulty in 2, needs of transfusion in 2 cases. 26 of 28 patients(85%) were completely dry or Improved in laparoscopic group; 82 of 87 patients(93%) In Raz group also showed complete dryness of improvement without significant difference in success rate between 2 groups. CONCLUSIONS: From our results, laparoscopic bladder neck suspension could shorten the duration of hospital stay and time to regaining normal voiding with early catheter removal. High success rate was also comparable to those of Raz operation. Laparoscopic BNS could applies as erective treatment modality for the surgical correction of anatomical stress urinary incontinence with its less invasiveness and early return to normal activities compared with the Raz procedure.