Burch colposuspension or sling for stress incontinence? A prospective study using transrectal ultrasound

Twenty-nine women with stress incontinence were treated surgically by Burch colposuspension or ox fascial sling. The operation was selected prospectively according to the transrectal ultrasound appearance of the bladder neck and urethra during stress. Two groups were defined according to the extent of bladder neck descent and posterior rotation during stress: Type I (minimal descent, i.e. less than 1.5 cm) and Type II (downward posterior rotational movement). Success rates of 76% are reported and the action of each procedure is discussed.