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Bladder neck suspension for stress urinary incontinence: how does it work?
J J Klutke1, C G Klutke, J Bergman
1Division of Urogynecology, Department of Obstetrics and Gynecology, USC School of Medicine, Los Angeles, California, USA.
Neurourology and Urodynamics
|October 26, 1999
Summary
Burch retropubic urethropexy significantly increases urethral resistance in patients cured of genuine stress urinary incontinence. Bladder neck support alone does not restore continence if urethral resistance is not improved.
Area of Science:
- Urology
- Female Pelvic Medicine
Background:
- Genuine stress urinary incontinence (SUI) affects many women.
- Burch retropubic urethropexy is a common surgical treatment for SUI.
Purpose of the Study:
- To evaluate the effect of Burch retropubic urethropexy on urethral resistance.
- To determine if bladder neck support alone restores continence.
Main Methods:
- Retrospective analysis of pressure-flow studies in 178 patients before and after Burch retropubic urethropexy.
- Assessment of urethral resistance, cotton swab tests, and urethral functional length.
- Statistical analysis using the two-tailed paired t-test.
Main Results:
- Successful Burch retropubic urethropexy significantly increased mean urethral resistance (0.051 to 0.099).
- In patients with failed surgery, mean urethral resistance remained unchanged (0.041).
- No direct correlation was found between bladder base stabilization and SUI cure.
Conclusions:
- Burch retropubic urethropexy enhances urethral resistance when successful in curing SUI.
- Restoring continence requires improved urethral resistance, not just bladder neck support.