Pelvic Organ Prolapse Repair With and Without Prophylactic Concomitant Burch Colposuspension in Continent Women: A Randomized, Controlled Trial With 8-Year Followup
- 30 June 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 185 (6), 2236-2240
- https://doi.org/10.1016/j.juro.2011.01.078
Abstract
We reevaluated and brought up to date the 8-year followup of a previous published, randomized, controlled trial of the impact of Burch colposuspension as a prophylactic anti-incontinence procedure in patients without urinary incontinence who underwent abdominal pelvic organ prolapse repair. A total of 66 continent women with pelvic organ prolapse were randomly assigned to abdominal pelvic organ prolapse repair and concomitant Burch colposuspension in 34 (group 1) or pelvic organ prolapse repair alone without an anti-incontinence procedure in 32 (group 2). Primary study end points were the anatomical outcome and changes in incontinence status. Secondary end points were changes in subjective symptoms and quality of life. Median followup was 97 months (range 72 to 134). Three group 1 and 1 group 2 patients were lost to followup. Three group 1 patients had a stage I rectocele and 1 had a stage I cystocele. Four group 2 patients had a stage I rectocele and 3 had a stage I cystocele. Nine of 31 group 1 patients (29%) were incontinent compared with 5 of 31 (16%) in group 2 (p = 0.553). In group 1 all except 1 patient were successfully treated for voiding dysfunction. Storage symptoms had disappeared in 1 patient and de novo storage symptoms had developed in 2 since the previous followup. De novo incontinence developed in 2 group 2 patients after midterm outcomes were reported. Median Urogenital Distress Inventory-6 and Incontinence Impact on Quality of Life-7 scores were improved in all groups at last followup (p 0.0001). Long-term results cast doubt on whether Burch colposuspension should be done during pelvic organ prolapse repair in continent women.Keywords
This publication has 17 references indexed in Scilit:
- Burch Colposuspension Does Not Provide Any Additional Benefit to Pelvic Organ Prolapse Repair in Patients With Urinary Incontinence: A Randomized Surgical TrialJournal of Urology, 2008
- Two-Year Outcomes After Sacrocolpopexy With and Without Burch to Prevent Stress Urinary IncontinenceObstetrics & Gynecology, 2008
- The age distribution, rates, and types of surgery for pelvic organ prolapse in the USAInternational Urogynecology Journal, 2007
- Must Colposuspension be Associated with Sacropexy to Prevent Postoperative Urinary Incontinence?European Urology, 2007
- Abdominal Sacrocolpopexy with Burch Colposuspension to Reduce Urinary Stress IncontinenceThe New England Journal of Medicine, 2006
- Reevaluating occult incontinenceCurrent Opinion in Obstetrics and Gynecology, 2005
- Pelvic Floor Muscle Behavior During Valsalva Leak Point Pressure Measurement in Males and Females Affected by Stress Urinary IncontinenceJournal of Urology, 2003
- URINARY INCONTINENCE IN BELGIUM; PREVALENCE, CORRELATES AND PSYCHOSOCIAL CONSEQUENCESActa Clinica Belgica, 2002
- The standardisation of terminology of lower urinary tract function: Report from the standardisation sub‐committee of the International Continence SocietyNeurourology and Urodynamics, 2002
- Epidemiology of surgically managed pelvic organ prolapse and urinary incontinenceObstetrics & Gynecology, 1997