Tension-free vaginal tape compared with laparoscopic Burch urethropexy

STUDY OBJECTIVE: To compare laparoscopic Burch colposuspension and tension-free vaginal tape (TVT) procedure in women with genuine stress incontinence. DESIGN: Randomized clinical study (Canadian Task Force classification I). SETTING: Tertiary care university hospital. PATIENTS: Forty-six consecutive women. INTERVENTION: Laparoscopic Burch colposuspension (23) and TVT procedure (23). MEASUREMENTS AND MAIN RESULTS: Valsalva leak-point pressure increased after surgery in both groups, but TVT substantially decreased maximum urinary flow rate. Other urodynamic studies showed no statistical differences. The groups did not differ significantly with respect to intraoperative complications or objective and subjective cure rates. Operating time was significantly longer for laparoscopic Burch (p = 0.001), and three patients in that group required conversion to laparotomy. Length of hospital stay (p = 0.003) and duration of catheterization (p = 0.003) were shorter in the TVT group. CONCLUSION: TVT holds promise in women with genuine stress incontinence, with several advantages over laparoscopic Burch.