(39,40) Randomized clinical trials comparing the TVT with the allogenic suburethral sling, (41) laparoscopic Burch, (42,43) and open Burch procedures
(44,45) demonstrate similar success rates for TVT versus these traditional procedures for the treatment of SUI.
Disadvantages of the open Burch procedure
are the abdominal incision, and--according to at least one study--lower efficacy in patients with intrinsic sphincter deficiency, he said.
Each TVT procedure generated 13 relative value units (RVUs) for reimbursement calculations, compared with 12.5 for a Burch procedure
. Physicians billed $4,190 for a TVT procedure and $3,797 for a Burch.
The major complication of the Burch procedure
is subsequent prolapse; however, this risk can be greatly reduced by careful intraoperative evaluation for potential future defects; which can be prevented by culdoplasty at the time of the Burch procedure
-- The tension-free vaginal tape and laparoscopic Burch procedures
to correct urinary incontinence have comparable 1-year success and complication rates, according to results of a small retrospective study.
Gill and his colleagues at Virginia Commonwealth University, Richmond, reviewed the records of 30 women who had the Burch procedure
for stress urinary incontinence and 151 women who underwent the Burch procedure
plus additional pelvic surgery.
A laparoscopic urethropexy procedure for retropubic suspension cost $1,389.93, while the traditional open Burch procedure
for retropubic suspension cost $5,279.40.
And since many of these patients will require a Burch procedure
or some other invasive treatment for incontinence, Dr.
LAS VEGAS -- The Burch procedure
can be performed laparoscopically and achieve results identical to those achieved by the open method.
This is unlike our previous published experience with repeat laparoscopic Burch procedures
following previous Burch or MMK.