CLINICAL AND URODYNAMIC CHARACTERISTICS OF WOMEN WITH RECURRENT URINARY-INCONTINENCE AFTER BURCH COLPOSUSPENSION

Objective. The purpose of this study was to determine the clinical and urodynamic characteristics of women with recurrent urinary incontinen ce after Burch colposuspension. Material. Fifty women subjectively com plaining of recurrent urinary incontinence (RUI) median 6 years after Burch colposuspension and 52 women with primary stress urinary inconti nence were examined during 1991-93. Methods. The participants were ass essed with medical history, uro-gynecological examination and urodynam ic investigation consisting of pad-test, urethrocystoscopy, cough prov ocation test, cystometry, urethra profilometry and flowmetry. Results. Women with RUI demonstrated significantly increased incidences of rec urrent lower urinary tract infection (24% vs. 8%), lumbago and sciatic a (66% vs. 38%), rectocele (80% vs. 21%), and enterocele (24% vs. O%) compared to women with primary stress urinary incontinence. Hypermobil ity of the bladder neck and urethra and palpable contraction of the le vator ani muscles was observed significantly more often among the wome n with primary stress incontinence (90% vs. 42% and 83% vs. 56%, respe ctively). The leakage in women with RUI was significantly less pronoun ced than among women with primary stress incontinence. Detrusor instab ility was found significantly more often in women with RUI (47.5% vs. 23%). Low urethra pressure was found in five women with RUI. Conclusio n. Women with RUI after Burch colposuspension seem to have a more pron ounced pelvic floor weakness than women with primary stress urinary in continence, whereas the urinary leakage is less pronounced. Recurrent lower urinary tract infection, lumbago and sciatica as well as detruso r instability are commonly observed whereas low urethral closure press ure is rare in women with RUI after Burch colposuspension.