[Functional and urodynamic results of Burch's colpopexy. A series of 173 cases]

The authors describe their experience with modified Burch retropubic urethropexy with a mean follow-up of 4 1/2 years; they clinically assessed 173 women. 114 of these had urodynamic studies. The long term objective success of this operative procedure, with a success rate of 95% in genuine stress incontinence and of 96% in correction of the cystocele, justify its use to cure urine loss in women with primary stress incontinence or after failure of a previous operation. The results do not get worse with a long term follow-up. The mechanism of action consists in improving the abdominal pressure transmission ration (+29%) with only a little decrease of the post-operative mean maximal urethral closure pressure (-8,8 cm H2O). The most challenging complication encountered was bladder instability (22.5%); post-operative retrocele or enterocele occurred in 15% of cases. The other side effects were dysuria, pubic pain and trachelocele. The rate of failure is nearly 5% mainly due to insufficient correction of the abdominal pressure transmission ration, or post-operative bladder instability or low urethral closure pressure.