Extraperitoneal approach to laparoscopic burch colposuspension

Study Objective. To evaluate 3-year outcomes of extraperitoneal laparoscopic colposuspension in treating genuine stress incontinence. Design. Retrospective review (Canadian Task Force classification 11-2). Setting. University-based, tertiary-level center for endoscopic surgery. Patients. One hundred sixty women with genuine stress incontinence with bladder neck hypermobility. Intervention. Extraperitoneal space was created with CO₂2 through a 10-mm midline port 2 cm above the pubic hairline. A pair of sutures was inserted at the level of midurethral and urethrovesical junction, fixing them to Cooper's ligament on each side with proper tension. Measurements and Main Results. Of 160 women, 10 were lost to follow-up. On follow-up questionnaire sent to 150 patients, 148 (98.7%) were pleased with the results of surgery. Stress incontinence was cured in 136 women (90.7%) after a minimum of 3 years' follow-up. Conclusion. Cure rates for extraperitoneal colposuspension were similar to those reported for traditional laparoscopic or laparotomy Burch procedures; however, this is a more direct method to expose the space of Retzius, thus eliminating the need to open and close peritoneum.