And compared with TVT, the laparoscopic Burch procedure
appears to take longer and may not be as effective, at least one study suggests.
The number of laparoscopic cases seen by fellows tended to be small: nine programs (53%) handled four or more laparoscopic Burch procedures
per year; five programs (29%) performed four or more laparoscopic vaginal suspensions per year; and three programs (18%) did four or more laparoscopic hysterectomies.
Horbach added that she's seeing a steadily increasing number of patients referred for mesh erosion and suture or staple erosion into the bladder following a laparoscopic Burch procedure
On the other hand, cystoscopy may be useful for detecting injuries if a Burch procedure
is being performed along with other gynecologic surgical procedures, he said.
These data are the first to show comparable long-term results when the Burch procedure
is performed in the identical manner laparoscopically as it is via laparotomy, according to Dr.
Stress continent women undergoing sacrocolpopexy for advanced pelvic organ prolapse were randomized to receive a concomitant standardized Burch colposuspension procedure or no Burch procedure
Head-to-head studies have found the Burch procedure
to be equally effective, compared with the synthetic retropubic sling, "but it's a little more invasive," said.
The TOMUS study uses a composite primary outcome measure, with objective and subjective components, similar to the outcome measures utilized in the UITN's recently completed Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr) trial (23) comparing the Burch procedure
to autologous fascial slings.
Long-term results of the Burch procedure
combined with abdominal sacrocolpopexy for treatment of vault prolapse.
2] In this multicentre, randomized clinical trial involving 655 women with stress incontinence, the 24-month success rate (success defined as negative pad test, no urinary incontinence [as recorded in a three-day diary], a negative cough and Valsalva stress test, no self-reported symptoms, and no retreatment for the condition) was higher for women who underwent the sling procedure than for those who underwent the Burch procedure
Although the model was better than random chance in predicting the probability of SUI after abdominal sacral colpopexy and Burch urethropexy in the CARE population, the accuracy was lower, perhaps "because women in the OPUS data set underwent sling with vaginal surgery for prolapse, while those in CARE underwent a Burch procedure
and abdominal surgery" he said.