GENUINE STRESS-INCONTINENCE - PROSPECTIVE RANDOMIZED COMPARISON OF 2 OPERATIVE METHODS

Eighty-one women with clinical and urodynamic findings of genuine stre ss incontinence and genital prolapse were randomly selected to be surg ically treated with either anterior colporrhaphy or Burch colposuspens ion. Each patient had a complete clinical and urodynamic evaluation be fore surgery and at 2 months and 3 years after surgery. Differences in cure rates between the two procedures at the 2-month post-operative e valuation were insignificant: however, at the 3-year post-surgical eva luation, the cure rate of women who had undergone Burch colposuspensio n was significantly higher than that of women who had undergone anteri or colporrhaphy (cure rates were 88% and 57%, respectively; P < 0.001) . The Burch colposuspension was more effective than the anterior colpo rrhaphy in the stabilization of the bladder base, neck and proximal ur ethra as confirmed by transvaginal sonography. Post-operative spontane ous voiding was uneventful in both procedures. Results of this study d emonstrate that the Burch colposuspension in our hands was more effect ive in treating genuine stress incontinence and pelvic relaxation than was anterior colporrhaphy.