A prospective randomized study comparing modified Burch retropubic urethropexy and suburethral sling for treatment of genuine stress incontinence with low-pressure urethra

OBJECTIVE: The aim of this study was to compare a modified Burch procedure with a suburethral sling for the treatment of stress incontinence complicat ed by a low-pressure urethra. STUDY DESIGN: Thirty-six women with stress incontinence, low-pressure ureth ra, and urethral hypermobility (straining cotton swab angle greater than or equal to 30 degrees) were randomly assigned to undergo either a modified B urch procedure (n = 19) or a suburethral sling (n = 17). Objective and subj ective cure rates at 3 months after the operation were the primary outcome measures. Comparisons of group means were performed with the Student t test for independent groups, and proportions were compared with the Fisher exac t test. RESULTS: After the operation the 2 groups had statistically similar cure ra tes and voiding function. Urethral closure pressure, pressure transmission ratios, and maximum detrusor pressure during voiding were significantly hig her in the sling group. CONCLUSION: At 3 months there were no clinically significant differences be tween the groups treated with suburethral sling and modified Burch procedur es.