Results of the colposuspension operation in pre and postmenopausal incontinent women

Objective: To compare the results of Burch colposuspension in premenopausal and postmenopausal women with urinary stress incontinence (USI). Methods: A total of 85 women with urodynamic diagnosis of genuine urinary stress inc ontinence were divided into two groups, according to their menstrual status (premenopausal and postmenopausal group). All of them underwent the Burch colposuspension procedure. Clinical and urodynamic data were compared preop eratively and postoperatively and between the two groups. Results: Cure rat e was significantly higher after Burch colposuspension in the premenopausal as compared to the postmenopausal patients (90.9 vs 73.1%, respectively, P < 0.01). A significant reduction of the diurnal and nocturnal frequency an d urgency was noted in both groups postoperatively. The reduction of urgenc y was more prominent in the premenopausal women (P < 0.001). There were no statistically significant differences between the preoperative and postoper ative values of bladder capacity, residual volume, maximal voiding pressure , peak flow rate, absolute urethral length, functional urethral length, ure thral pressure and maximum urethral closure pressure both preoperatively an d postoperatively within the groups and between the two groups. Comparing t he two groups postoperatively, the pressure transmission ratios in the post menopausal women were found to be significantly lower in the middle two qua rters of the urethra as compared to the premenopausal patients (P < 0.001). Conclusion: Burch colposuspension for urinary stress incontinence has bett er cure rate in premenopausal than in postmenopausal women. Nevertheless, t he above procedure remains an acceptable method for treatment of USI in pos tmenopausal patients. (C) 1998 Elsevier Science Ireland Ltd. All rights res erved.