A Prospective Study of Minimally Invasive Burch Colposuspension: Our Experience

Background: Stress urinary incontinence (SUI) is a common condition among women and can significantly affect quality of life. Although midurethral sling procedures are widely used, Burch colposuspension remains an important non-mesh surgical option, particularly in women undergoing concomitant abdominal or laparoscopic procedures. This study evaluated the perioperative safety and clinical outcomes of minimally invasive laparoscopic Burch colposuspension in women with genuine SUI. Material and Methods: A prospective longitudinal study was conducted at GEM Hospital and Research Centre, Coimbatore, between January 2017 and April 2018. Twenty-four women aged 22–80 years with urodynamically confirmed genuine SUI were included. Laparoscopic Burch colposuspension was performed through either a transperitoneal or extraperitoneal approach. Patients were assessed postoperatively for resolution of symptoms and complications, with scheduled follow-up at one week, three months, and twelve months. Long-term follow-up was continued for up to three years. Data were entered in Microsoft Excel and analysed using Jamovi version 2.7.32. Results: All 24 women successfully underwent laparoscopic Burch colposuspension. The mean age was 45.21 ± 10.57 years and the mean body mass index was 29.29 ± 5.81 kg/m². The extraperitoneal approach was used in 13 patients (54.2%) and the transperitoneal approach in 11 (45.8%). Seventeen patients (70.8%) underwent concomitant laparoscopic procedures. The mean operative time was 43 minutes and the mean estimated blood loss was 38.13 ± 15.23 mL. No major intraoperative complications and no patient required conversion to laparotomy. The mean hospital stay was 2 days. Two patients (8.3%) developed postoperative urinary tract infection, which was managed conservatively. At three-year follow-up, no recurrence or persistence of SUI symptoms was reported. Conclusion: Minimally invasive laparoscopic Burch colposuspension demonstrated favourable perioperative safety and satisfactory long-term continence outcomes in women with SUI. It may remain a useful mesh-free surgical option.

Keywords: Stress urinary incontinence; Burch colposuspension; laparoscopy; minimally invasive surgery.