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Burch colposuspension: a 10-20 year follow up
M Alcalay1, A Monga, S L Stanton
1Department of Obstetrics and Gynaecology, St. George's Hospital, London, UK.
British Journal of Obstetrics and Gynaecology
|September 1, 1995
Summary
Burch colposuspension success for stress incontinence declines over 10-12 years, plateauing at 69%. Previous surgery and higher weight negatively impact long-term cure rates.
Area of Science:
- Urogynecology
- Female Pelvic Medicine and Reconstructive Surgery
Background:
- Burch colposuspension is a surgical procedure for genuine stress incontinence.
- Long-term outcomes and factors influencing success require further investigation.
Purpose of the Study:
- To evaluate the long-term success of Burch colposuspension.
- To identify factors affecting the durability of the procedure.
Main Methods:
- Longitudinal retrospective study of 109 women with genuine stress incontinence.
- Survival analysis was used to assess subjective and objective cure rates.
- Follow-up extended to 10-20 years post-surgery.
Main Results:
- Success rates for Burch colposuspension are time-dependent, declining for 10-12 years to a plateau of 69%.
- Factors associated with lower success include prior bladder neck surgery, pre-operative weight >80 kg, blood loss >1000 ml, and post-operative detrusor instability.
- Complications included de novo detrusor instability (14.7%), voiding difficulties (22%), and recurrent UTIs (4.6%).
Conclusions:
- Long-term follow-up is essential to evaluate the sequelae of colposuspension.
- New continence procedures should be monitored for at least 5-10 years.