» Articles » PMID: 27607858

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy: A Randomized Controlled Trial

Overview
Journal Obstet Gynecol
Date 2016 Sep 9
PMID 27607858
Citations 7
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: To compare efficacy and safety of retropubic Burch urethropexy and a midurethral sling in women with stress urinary incontinence (SUI) undergoing concomitant pelvic floor repair with sacrocolpopexy.

Methods: Women were randomly assigned to Burch retropubic urethropexy (n=56) or retropubic midurethral sling (n=57) through dynamic allocation balancing age, body mass index, history of prior incontinence surgery, intrinsic sphincter deficiency, preoperative incontinence diagnosis, and prolapse stage. Overall and stress-specific continence primary outcomes were ascertained with validated questionnaires and a blinded cough stress test.

Results: Enrollment was June 1, 2009, through August 31, 2013. At 6 months, no difference was found in overall (29 midurethral sling [51%] compared with 23 Burch [41%]; P=.30) (odds ratio [OR] 1.49, 95% confidence interval [CI] 0.71-3.13) or stress-specific continence rates (42 midurethral sling [74%] compared with 32 Burch [57%]; P=.06) (OR 2.10, 95% CI 0.95-4.64) between groups. However, the midurethral sling group reported greater satisfaction (78% compared with 57%; P=.04) and were more likely to report successful surgery for SUI (71% compared with 50%; P=.04) and to resolve pre-existing urgency incontinence (72% compared with 41%; P=.03). No difference was found in patient global impression of severity or symptom improvement, complication rates, or mesh exposures.

Conclusion: There was no difference in overall or stress-specific continence rates between midurethral sling and Burch urethropexy groups at 6 months. However, the midurethral sling group reported better patient-centered secondary outcomes.

Citing Articles

Defining success after surgical treatment of stress urinary incontinence.

Raju R, Madsen A, Linder B, Occhino J, Gebhart J, McGree M Am J Obstet Gynecol. 2024; 231(2):235.e1-235.e16.

PMID: 38527605 PMC: 11283962. DOI: 10.1016/j.ajog.2024.03.034.


Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery.

Margulies S, Sakai N, Geller E Int Urogynecol J. 2023; 35(1):35-42.

PMID: 37392225 DOI: 10.1007/s00192-023-05583-5.


A comprehensive look at risk factors for mid-urethral sling revision surgery.

Keslar M, Margossian H, Katz J, Lakhi N Int Urogynecol J. 2020; 31(4):779-784.

PMID: 32034459 DOI: 10.1007/s00192-020-04233-4.


Revisiting current treatment options for stress urinary incontinence and pelvic organ prolapse: a contemporary literature review.

Wu Y, Welk B Res Rep Urol. 2019; 11:179-188.

PMID: 31355157 PMC: 6590839. DOI: 10.2147/RRU.S191555.


Outcomes of stress urinary incontinence in women undergoing TOT versus Burch colposuspension with abdominal sacrocolpopexy.

Lazarou G, Minis E, Grigorescu B Int Urogynecol J. 2018; 30(2):245-250.

PMID: 29725708 DOI: 10.1007/s00192-018-3668-5.


References
1.
Habibi J, Petrossian A, Rapp D . Effect of Transobturator Midurethral Sling Placement on Urgency and Urge Incontinence: 1-Year Outcomes. Female Pelvic Med Reconstr Surg. 2015; 21(5):283-6. DOI: 10.1097/SPV.0000000000000181. View

2.
Wu J, Kawasaki A, Hundley A, Dieter A, Myers E, Sung V . Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol. 2011; 205(3):230.e1-5. PMC: 3630997. DOI: 10.1016/j.ajog.2011.03.046. View

3.
Blaivas J, Panagopoulos G, Weiss J, Somaroo C . Validation of the overactive bladder symptom score. J Urol. 2007; 178(2):543-7. DOI: 10.1016/j.juro.2007.03.133. View

4.
Samuelsson E, Victor F, Tibblin G, Svardsudd K . Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 1999; 180(2 Pt 1):299-305. DOI: 10.1016/s0002-9378(99)70203-6. View

5.
Ward K, Hilton P . Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ. 2002; 325(7355):67. PMC: 117136. DOI: 10.1136/bmj.325.7355.67. View