Author/Editor		Lukanovič, Adolf
Title		Endoskopska kolposuspenzija po Burchu - nov pristop kirurškega zdravljenja stresne urinske inkontinence
Translated title		Endoscopic Burch colposuspension - a new method of surgical treatment for stress urinary incontinence
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 2, št. 3
Publication year		1997
Volume		str. 9-17
Language		slo
Abstract		Background. Thanks to its advantages over classical surgical procedures, minimally invasive surgery has also found its place in urogynaecology. Today, colposuspension sec. Burch is certainly one of the most widely used operative techniques for treating stress urinary incontinence. Bladder neck suspension in stress urinary incontinent women can be accomplished by using a new endoscopic procedure. Patients and mehods. In the past year, extraperitoneal endoscopic Burch colposuspension involving preperitoneal baloon distension of the space of Retzius was carried out in five patients with stress urinary incontinence, admitted to the Department of Obstetrics and Gynaecology, Ljubljana. A single non-absorbable suture on either side of the bladder neck was fixed on to the Cooper's ligament, like in an open procedure. The knot was tied extracorporeally. Results. In all five patients, the diagnosis of stress urinary incontinence was confirmed by urodynamic measurements prior to surgery. Three months postoperatively, the outcome of surgery was assessed both subjectively and objectively. All patients were able to return to work two weeks after the operation. Conclusions. Endoscopic Burch colposuspension is a relatively simple and safe operation, which is well tolerated by the patients and yields excellent short-term results. The final outcome, however, can only be assessed five years postoperatively. The described operative technique combines the advantages of classical open operation with those of minimally invasive surgery.
Summary		Izhodišča. Minimalna invazivna kirurgija je zaradi prednosti pred klasično našla svoje mesto tudi v urološki ginekologiji. Ena najpogostejših operacij za zdravljenje stresne urinske inkontinence danes je kolpouretrocistopeksija po Burchu. Suspenzija vratu sečnega mehurja pri stresni urinski inkontinenci pa je izvedljiva tudi z endoskopskim posegom. Bolnice in metode. V letu 1996 smo na Ginekološki kliniki pri petih bolnicah s stresno urinsko inkontinenco naredili endoskopsko ekstraperitonealno kolposuspenzijo po Burchu z uporabo balona za raztegnitev Retziusovega prostora. En neresorbilen šiv na vsaki strani paravaginalne fascije ob vratu sečnega mehurja smo prišili na Cooperjev ligament kot pri odprti operaciji. Šiv smo vozljali zunaj telesa. Rezultati. Pri vseh petih bolnicah smo diagnozo stresne urinske inkontinence potrdili pred operacijo z urodinamskimi meritvami. 14 dni po operaciji so bile vse bolnice že na svojem delovnem mestu. Tri mesece po operaciji smo ugotovili subjektivno in objektivno izboljšanje. Zaključek. Endoskopska kolposuspenzija po Burchu je sorazmerno enostana in varna operacija. Bolnice jo dobro prenašajo. Kratkoročni rezultati so odlični. Vendar bomo uspešnost operacije ocenili šele na osnovi analize petletnih rezultatov. Opisana operacija združuje dobre strani klasične odprte operacije s prednostmi minimalne invazivne kirurgije.
Descriptors		URINARY INCONTINENCE, STRESS BLADDER SURGERY, ENDOSCOPIC