PROGNOSTIC FACTORS AND LONG-TERM RESULTS OF THE BURCH COLPOSUSPENSION- A RETROSPECTIVE STUDY

The purpose of this retrospective study was to evaluate the importance of different preoperative estimates and postoperative complications o n the outcome of the Burch colposuspension with respect to urinary con tinence. During the period 1980-1988 243 women were operated upon with the Burch colposuspension for stress incontinence or mixed incontinen ce. The patient records have been analysed with respect to preoperativ e assessments and postoperative complications. 236 patients were alive at the follow-up, median 6 years after operation, and 232 (98%) answe red a postal questionnaire about their present urinary symptoms. Accor ding to the postal questionnaire the overall cure-rate was 63 per cent , another 27 per cent were improved. Prognostic factors for an unsucce ssful outcome of the operation were previous urinary incontinence surg ery, postoperative febrile morbidity, and immediate voiding difficulti es (stranguria and difficulties emptying the urinary bladder). At the follow-up the voiding difficulties were still significantly more often seen in patients not cured from incontinence than among women cured b y the colposuspension. Among the patients with recurrent incontinence we also found a significantly higher rate of lower urinary tract infec tions (>3 UTI per year). The continence rate was found to be almost co nstant between the second and tenth year postoperatively. No significa nt differences in preoperatively measured maximal urethral closure pre ssure and functional urethral length were found between cured and not cured patients. Although not significant, the cure-rate showed a tende ncy to decrease with age at the operation, both in the short-term resu lt as well as the long-term result.