Laparoscopic versus conventional surgical treatment of genuine urinary stress incontinence

ABSTRACT

To compare laparoscopic versus the classical open colposuspension in surgical treatment of GSI. The study was conducted on 20 patients diagnosed to have GSI. P re-operative evaluation entailed stress test, Q-tip test and urodynamic study including combined cystometry and pressure flow study. Ten cases were subject to laparoscopic Burch colposuspension using non-absorbable suture between Cooper's ligament and vaginal vault. Ten cases were subjected to classical open Burch procedure. Post-operative evaluation was done. Clinical and urodynamic tests were rechecked one month after surgery. Operating time was significantly longer in laparoscopic group [3.25 hours] as compared to open group [1.25 hours]. One case of bladder perforation was recognized intraoperatively in laparoscopic group. Analgesic requirement was significantly less in laparoscopy cases. Hospital stay was found to be significantly shorter in laparoscopic group [4.8 days] than in open group [8.1 days]. Two cases of wound infection were reported in cases of open group. Urodynamic studies revealed comparable results in both groups one month after operation, all in favour of restoration of normal continence. One case [10%] of recurrence was found in each group. Laparoscopic Burch colposuspension is a safe and effective procedure for GSJ. Laparoscopic approach provides better visibility, more precise haemostasis, less post-operative discomfort, quicker recovery and shorter hospital stay