The Burch Procedure: A Comprehensive Review

The purpose of this review is to provide the obstetrician/gynecologist with a comprehensive review of the open Burch procedure including operative technique and modifications, complications, and success rates.A computerized search of English-language articles was performed on the MEDLINE database. Additional sources were identified through cross-referencing. All identified articles were reviewed with particular attention to operative technique, complication, and success rates. Each reference was reviewed; operative technique and modifications are cited, and all complications are reported here. Overall success rates by length of follow-up are tabulated. Several comparative studies are cited. The Burch procedure via laparotomy has undergone minimal modification since its initial description in 1961. Complications including voiding dysfunction, detrusor instability, and urinary tract infection occur in up to 41 percent of patients, but more serious sequelae such as urinary tract injury, hemorrhage, or venous thromboembolism are rare. Long-term success rates of the Burch procedure range from 61 to 100 percent, which are as good or better than any other incontinence procedure. TARGET AUDIENCEObstetricians & Gynecologists, Family Physicians LEARNING OBJECTIVESAfter completion of this article, the reader will be able to describe the diagnostic evaluation of stress urinary incontinence, cite possible risk factors for surgical failure of the Burch procedure, describe various modifications of the original Burch procedure, and cite success and complication rates of the Burch procedure.