Clinical Outcomes

Reported continence rates for laparoscopic Burch colposuspension vary from 69% to 100%.3 Only half of the studies presented objective outcomes. Most authors reported less blood loss, shorter hospitalization, and less-frequent postoperative voiding dysfunction and de novo detrusor instability when compared with the abdominal route.

A recent systematic review5 of laparoscopic colposuspension summarized the findings of five randomized6-10 and three "quasi-randomized" trials.11-13 Analysis of subjective perception of cure showed no difference between open and laparoscopic colposuspension. When one poor-quality trial9 was excluded from the analysis for objective cure, the relative risk of a positive stress test at follow-up was less in the open colposuspension group but not significantly so when compared with the laparoscopic group. Based on a single trial, two stitches are better than one.11 The authors concluded that the evidence is limited by short-term follow-up and small numbers; therefore, valid conclusions are difficult to make. A current randomized clinical trial at our institution comparing laparoscopic Burch colposuspension and the tension-free vaginal tape procedure demonstrates superior subjective and urody-namic cure in the tension-free vaginal tape group at a median of 24.5 months. However, the sample size of our study is relatively small with 36 patients in each group and 2-year follow-up of all subjects is not yet complete. Cost was similar for both procedures.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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