BURCH COLPOSUSPENSION VERSUS MODIFIED MARSHALL-MARCHETTI-KRANTZ URETHROPEXY FOR PRIMARY GENUINE STRESS URINARY-INCONTINENCE - A PROSPECTIVE, RANDOMIZED CLINICAL-TRIAL

OBJECTIVE: Our purpose was to compare the effects of the Burch colposu spension with those of the modified Marshall-Marchetti-Krantz urethrop exy. STUDY DESIGN: Eighty women underwent the two types of operation. A full urodynamic investigation was repeated 6 months after surgery. R ESULTS: Clinical follow-up continued for 2 to 7 years. Differences in subjective and objective cure rates were not statistically significant (respectively, 92% and 80% for the Burch colposuspension and 85 and 6 5% for the modified Marshall-Marchetti-Krantz urethropexy). The latter induced a longer hospital stay (7.4 vs 6.3 days, p = 0.001), a later resumption of spontaneous voiding (13.8 vs 8.5 days, p = 0.002), and w as associated with considerable complications (one case of blood repla cement for retropubic hematoma, one case of severe voiding difficulty, one case of further treatment for stress incontinence, and three case s of symptomatic de novo detrusor instability). CONCLUSION: For its hi gh cure rate, short time to resumption of spontaneous voiding, short h ospital stay, and low associated morbidity, the Burch colposuspension should remain the procedure of choice for stress incontinence.