LONG-TERM RESULTS AFTER BURCH COLPOSUSPENSION

OBJECTIVE: Our purpose was to review the long-term (5 to 10 years) cli nical and urodynamic outcome in patients with stress urinary incontine nce after Burch colposuspension. STUDY DESIGN: A follow-up of 87 women with stress urinary incontinence who had a Burch colposuspension betw een 1979 and 1985 at the Department of Obstetrics and Gynecology, Univ ersity of Berne, was performed by clinical and urodynamic reevaluation of the patients. RESULTS: Stress incontinence was cured in 81.6% of p atients. The cure rate was not significantly related to age, hormonal status, body weight, or previous surgical procedures for incontinence. Burch colposuspension stabilized the urethrovesical junction. Urodyna mic measurement at follow-up compared with the preoperative evaluation showed in the cured group a significant increase in (1) the functiona l urethral length at rest and at stress, (2) maximum urethral closure pressure at stress, and (3) pressure transmission. On the contrary, in unsuccessful operations none of the recorded parameters had improved. Women with failed surgery had significantly lower preoperative maximu m urethral closure pressures at rest and at stress, lower continence a reas, smaller functional urethral lengths at stress, smaller length to peak pressures, and lower index values of urethral relaxation at stre ss. The procedure had a low operative and postoperative morbidity, wit h no significant disturbance of voiding function noted at 5 to 10 year s' follow-up. CONCLUSIONS: Our results with the Burch colposuspension showed a high success rate at 5 to 10 years' follow-up. The high cure rate and low operative and postoperative morbidity were related to car eful preoperative selection.