Background
The negative media attention surrounding vaginal mesh procedures has seen a rise in demand for minimally invasive non‐mesh options for the treatment of stress urinary incontinence (SUI). The laparoscopic Burch colposuspension (LBC) is a non‐mesh alternative to synthetic midurethral slings (MUS) with similar short‐term outcomes. However, long‐term outcomes are not well established.

Aims
To evaluate the long‐term outcomes of LBC for treatment of SUI in women.

Material and Methods
One hundred and fifty‐one cases of LBC were performed by a single surgeon over two private hospital settings between January 2010 and January 2016. Follow‐up subjective outcomes were obtained in 137 cases (90.7%) utilising standardised questionnaires. Primary outcome was successful treatment of SUI, defined as subjective cure or significant improvement of stress incontinence symptoms. Secondary outcomes included new‐onset or worsened symptoms of overactive bladder (OAB), voiding dysfunction, prolapse, and perioperative complications.

Results
One hundred and thirty‐seven patients were analysed with a mean follow‐up of 50.6 months (range: 13–89 months). Primary outcome of successful treatment was achieved in 90.5% of women. New‐onset or worsened symptoms of OAB was reported in 10.2%, with a further 8.8% of women experiencing symptomatic voiding dysfunction. Sixteen patients (11.7%) reported new‐onset or worsening symptoms of prolapse. There were no major surgical complications.

Conclusions
LBC is a safe and effective long‐term treatment for SUI, with low failure rates and minimal adverse outcomes. It is a suitable alternative for women with contraindications to mesh or those having concomitant laparoscopic procedures.