M Alcalay1, A Monga, S L Stanton. 1. Department of Obstetrics and Gynaecology, St. George's Hospital, London, UK.
Abstract
OBJECTIVE: To review the outcome of women who underwent Burch colposuspension 10 to 20 years ago and to assess factors which affect long term success. DESIGN: Longitudinal retrospective study. SETTING: Urogynaecology Unit, St George's Hospital, London. SUBJECTS: One hundred and nine women with genuine stress incontinence. MAIN OUTCOME MEASURES: Survival analysis of subjective and objective cure of stress incontinence. RESULTS: Cure of incontinence following Burch colposuspension is time-dependent, with a decline for 10 to 12 years when a plateau of 69% is reached. Factors adversely affecting cure are previous bladder neck surgery (logrank test P = 0.02), pre-operative weight greater than 80 kg, intra-operative blood loss more than 1000 ml and the development of post-operative detrusor instability. Post-operative complications included de novo detrusor instability (14.7%), long term complaints of voiding difficulty with objective recovery at the final follow up (22%) and recurrent urinary tract infection (4.6%). CONCLUSIONS: Long term follow up after colposuspension is necessary to assess sequelae. We suggest that new continence procedures should be followed up for 5 to 10 years.
OBJECTIVE: To review the outcome of women who underwent Burch colposuspension 10 to 20 years ago and to assess factors which affect long term success. DESIGN: Longitudinal retrospective study. SETTING: Urogynaecology Unit, St George's Hospital, London. SUBJECTS: One hundred and nine women with genuine stress incontinence. MAIN OUTCOME MEASURES: Survival analysis of subjective and objective cure of stress incontinence. RESULTS: Cure of incontinence following Burch colposuspension is time-dependent, with a decline for 10 to 12 years when a plateau of 69% is reached. Factors adversely affecting cure are previous bladder neck surgery (logrank test P = 0.02), pre-operative weight greater than 80 kg, intra-operative blood loss more than 1000 ml and the development of post-operative detrusor instability. Post-operative complications included de novo detrusor instability (14.7%), long term complaints of voiding difficulty with objective recovery at the final follow up (22%) and recurrent urinary tract infection (4.6%). CONCLUSIONS: Long term follow up after colposuspension is necessary to assess sequelae. We suggest that new continence procedures should be followed up for 5 to 10 years.
Authors: James S Dunn; Alfred E Bent; R Mark Ellerkman; Mikio A Nihira; Clifford F Melick Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2003-12-19
Authors: K-P Jünemann; H Palmtag; C Hampel; H Heidler; G Naumann; H Kölbl; C van der Horst; D Schultz-Lampel Journal: Urologe A Date: 2006-09 Impact factor: 0.639
Authors: Kenneth I Barron; Judith A Savageau; Stephen B Young; Lisa C Labin; Abraham N Morse Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2006-04-01