OBJECTIVE: The objective of the study was to examine changes in bladder symptoms 1 year after abdominal sacrocolpopexy (ASC) with vs without Burch colposuspension. STUDY DESIGN:Women without stress urinary incontinence (SUI) symptoms undergoing ASC were randomized to receive or not receive Burch. One year later, irritative, obstructive, and SUI symptoms were assessed in 305 women using Urogenital Distress Inventory subscales. A composite "stress endpoint" combined SUI symptoms, positive stress test, and retreatment. RESULTS: In all women, the mean irritative score decreased from 19.6 +/- 16.3 (mean +/- SD) to 9.1 +/- 10.6; for obstructive symptoms, from 34.8 +/- 21.0 to 6.3 +/- 10.4 (both P < .001). Preoperative bothersome irritative symptoms resolved in 74.6% (126 of 169) and obstructive symptoms in 85.1% (212 of 249), independent of Burch. Fewer women with Burch had urge incontinence (14.5% vs 26.8%, P = .048) and fulfilled the stress endpoint (25.0% vs 40.1%, P = .012). CONCLUSION:ASC reduced bothersome irritative and obstructive symptoms. Prophylactic Burch reduced stress and urge incontinence.
RCT Entities:
OBJECTIVE: The objective of the study was to examine changes in bladder symptoms 1 year after abdominal sacrocolpopexy (ASC) with vs without Burch colposuspension. STUDY DESIGN:Women without stress urinary incontinence (SUI) symptoms undergoing ASC were randomized to receive or not receive Burch. One year later, irritative, obstructive, and SUI symptoms were assessed in 305 women using Urogenital Distress Inventory subscales. A composite "stress endpoint" combined SUI symptoms, positive stress test, and retreatment. RESULTS: In all women, the mean irritative score decreased from 19.6 +/- 16.3 (mean +/- SD) to 9.1 +/- 10.6; for obstructive symptoms, from 34.8 +/- 21.0 to 6.3 +/- 10.4 (both P < .001). Preoperative bothersome irritative symptoms resolved in 74.6% (126 of 169) and obstructive symptoms in 85.1% (212 of 249), independent of Burch. Fewer women with Burch had urge incontinence (14.5% vs 26.8%, P = .048) and fulfilled the stress endpoint (25.0% vs 40.1%, P = .012). CONCLUSION: ASC reduced bothersome irritative and obstructive symptoms. Prophylactic Burch reduced stress and urge incontinence.
Authors: Holly E Richter; Kathryn L Burgio; Toby C Chai; Stephen R Kraus; Yan Xu; Lee Nyberg; Linda Brubaker Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2009-01-30
Authors: Dharmesh S Kapoor; Marika Nemcova; Konstantinos Pantazis; Paula Brockman; Luigi Bombieri; Robert M Freeman Journal: Int Urogynecol J Date: 2009-09-11 Impact factor: 2.894
Authors: Linda Brubaker; Ingrid Nygaard; Holly E Richter; Anthony Visco; Anne M Weber; Geoffrey W Cundiff; Paul Fine; Chiara Ghetti; Morton B Brown Journal: Obstet Gynecol Date: 2008-07 Impact factor: 7.661
Authors: Matthew J Aungst; Thaddeus D Mamienski; Todd S Albright; Christopher M Zahn; John R Fischer Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2009-04-08