Genital prolapse in women treated successfully and unsuccessfully by the Burch colposuspension

The aim of the study was to determine the correlation between genital prolapse and the outcome of the Burch colposuspension.

Fifty women with objectively proven recurrent incontinence after Burch colposuspension and 31 women, objectively continent after the colposuspension, were clinically examined with emphasis on genital prolapse. The preoperative vaginal profile of the women was estimated from the patient records.

The preoperative vaginal profile demonstrated no significant differences in occurrence of prolapse components between the women who were continent after the colposuspension and those women who had recurrent incontinence. At the follow-up, rectocele and cystocele occurred with significantly higher frequencies among the women with recurrent urinary incontinence than among the women who were continent after the Burch colposuspension (80% and 46% vs. 42% and 10%; p<0.01). Enterocele and uterine/vaginal vault descent occurred in equal frequencies in the two groups. Independent of the outcome of the colposuspension, the women with rectocele were significantly younger than the women without rectocele (55 years vs. 63.5 years; p<0.01).

The results imply an association between the occurrence of rectocele and cystocele and the outcome of the colposuspension. Different etiologies seem to exist for rectocele/cystocele, compared to enterocele or uterine/vaginal vault descent formation in women with stress urinary incontinence, operated upon with the Burch colposuspension.