A prospective randomized study comparing modified Burch retropubic urethropexy and suburethral sling for treatment of genuine stress incontinence with low-pressure urethra

• Published in: American journal of obstetrics and gynecology Vol. 182; no. 1; pp. 30 - 34
• Main Authors: Sand, Peter K., Winkler, Harvey, Blackhurst, Dawn W., Culligan, Patrick J.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.01.2000; Elsevier
• Subjects: Aged; Biological and medical sciences; Burch; Female; Humans; Length of Stay; Medical sciences; Middle Aged; Muscle, Smooth - physiopathology; Nephrology. Urinary tract diseases; Postoperative Care; Postoperative Complications; Pressure; Prospective Studies; sling; stress incontinence; Urethra - physiopathology; Urethra - surgery; urethropexy; Urinary Bladder - physiopathology; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - surgery; Urinary Retention; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Burch; urethropexy; sling; stress incontinence; Human; Urethropexy; Urinary system disease; Sex; Urinary tract disease; Voiding dysfunction; Treatment; Surgery; Female; Bladder disease; Technique; Comparative study; Urinary stress incontinence
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(00)70487-X

Objective: The aim of this study was to compare a modified Burch procedure with a suburethral sling for the treatment of stress incontinence complicated by a low-pressure urethra. Study Design: Thirty-six women with stress incontinence, low-pressure urethra, and urethral hypermobility (straining cotton swab angle ≥30°) were randomly assigned to undergo either a modified Burch procedure (n = 19) or a suburethral sling (n = 17). Objective and subjective cure rates at 3 months after the operation were the primary outcome measures. Comparisons of group means were performed with the Student t test for independent groups, and proportions were compared with the Fisher exact test. Results: After the operation the 2 groups had statistically similar cure rates and voiding function. Urethral closure pressure, pressure transmission ratios, and maximum detrusor pressure during voiding were significantly higher in the sling group. Conclusion: At 3 months there were no clinically significant differences between the groups treated with suburethral sling and modified Burch procedures. (Am J Obstet Gynecol 2000;182:30-4.)