Prolapse
Landmark Papers by Adlap Surgeons
Correction of genital prolapse
Liu CY, Reich H
J Endourol 1996 Jun;10(3):259-
Massive eversion of the vagina is one of the most disturbing disorders confronting
a woman. It is a complex disorder that always coexists with other pelvic
floor defects. The management is almost always surgical, and all defects
must be repaired concomitantly. Current surgical practice relies primarily
on the strength of the endopelvic fascia and certain ligaments, which clearly
is not ideal for providing the kind of support needed. Current understanding
of the neurophysiology, neuroanatomy, and biophysics of the pelvic floor
give us hope that management will be more effective in the future. Laparoscopic
repair techniques are described.
Laparoscopic retropubic colposuspension (Burch procedure)
Liu CY, Paek W
J Am Assoc Gynecol Laparosc 1993 Nov;1(1):31-
Laparoscopic retropubic colposuspension (Burch procedure) was performed
in 107 patients for the treatment of genuine stress urinary incontinence.
The overall success rate was 97.2%, and overall complication rate 10.2%.
Patients experienced minimal blood loss, shorter hospital stay, and faster
recovery than with the traditional approach by laparotomy, confirming the
findings of an initial study of 58 patients. Although follow-up has been
relatively short (range 3-27 mo), it appears that laparoscopic retropubic
colposuspension is a feasible and safe alternative to the abdominal procedure
in appropriately selected patients.
Laparoscopic retropubic colposuspension (Burch procedure).A review
of 58 cases
Liu CY
J Reprod Med 1993 Jul;38(7):526-Fifty-eight patients underwent laparoscopic
retropubic colposuspension (Burch procedure) for the treatment of genuine
urinary stress incontinence. Of these 58 patients, 3 developed postoperative
detrusor instability, and another 2 had bladder injuries. The overall complication
rate was 8.5%, and the success rate was 94.83%. Our limited experience has
shown many advantages of laparoscopic retropubic colposuspension over the
traditional abdominal retropubic colposuspension; they include easy access
to the space of Retzius, better visibility in the operative field, minimal
intraoperative blood loss and postoperative need for pain medication, and
shortened hospital stay and recovery period. Most patients were discharged
from the hospital within 24-36 hours and resumed normal activities within
seven days. Previous major pelvic surgery is not a contraindication to this
procedure. Based on our initial experience, laparoscopic retropubic colposuspension
appears to be a viable alternative to abdominal retropubic colposuspension.