Burch colposuspension and the retropubic mid-urethral sling for the treatment of female urinary incontinence
IUGA Academy. Villegas R. 06/30/18; 213065; 371 Topic: Stress Incontinence
Rocio Villegas
Rocio Villegas

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Burch colposuspension and the retropubic mid-urethral sling for the treatment of female urinary incontinence

Villegas, R1; Alvarez, J2; Rondini, C2; Urzua, MJ3; Andreoli, F4; Storme, O4

1: Hospital Padre Hurtado and Clinica Alemana Chile; 2: Hospital Padre Hurtado and Clinica Santa Maria Chile; 3: Hospital Padre Hurtado and Clinica Davila; 4: Hospital Padre Hurtado

Introduction: Recently, regulatory entities such as the FDA have published warnings with regards to the use of vaginal mesh in reconstructive pelvic surgeries. Unfortunately, this has also impacted the use of mesh for the treatment of female stress urinary incontinence. In response to this situation many pelvic floor surgeons have made an attempt to revive previous techniques such as the Burch colposuspension.

Objective: The aim of this study is to review the success of the Burch colposuspension compared to today´s gold standard the retropubic mid-urethral sling (MUS).

Methods: We conducted a retrospective study of women who underwent either a Burch colposuspension or a retropubic MUS. Information was obtained from patient´s medical records and surgical notes. Clinical follow-up was performed at 1, 3, 6, 12 months and yearly thereafter. Success was considered NO stress urinary incontinence reported by the patient at follow up. Secondary objective was patients reported symptoms such as over active bladder symptoms and voiding difficulty/pain.

Results: During the study period analyzed 234 women underwent a Burch colposuspension and 72 a retropubic MUS. We found significant difference among demographic variables between each group: Age (Burch 50.8 vs., MUS 52.9 p: 0.042), parity (Burch 3.8 vs., MUS3.2 p: 0.001 ), BMI ( Burch 28.6 vs., MUS 26.4 p: 0.035). Patient reported success was significantly higher in the retropubic group (Burch 150/234 vs., MUS 60/72 p. 0.001) as well as less overactive bladder symptoms in the retropubic group (Burch 26.6% vs., MUS 9.6% p. 0.001). However no significant difference was found in voiding pain or difficulty (Burch 7.9% vs., 9.1% p. 0.439). The hospital stay was significantly higher in the Burch ( ), yet we found no differences in surgical complications.

Conclusion: The Burch colposuspension continuous to be a viable option for the treatment of stress urinary incontinence in women who do not desire a mesh procedure, however this comes at a decrease success rate which must be discuss with our patients.


Work supported by industry: no.

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