Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Apr;187(4):1324-30.
doi: 10.1016/j.juro.2011.11.087. Epub 2012 Feb 15.

5-year continence rates, satisfaction and adverse events of burch urethropexy and fascial sling surgery for urinary incontinence

L Brubaker  1 , H E Richter, P A Norton, M Albo, H M Zyczynski, T C Chai, P Zimmern, S Kraus, L Sirls, J W Kusek, A Stoddard, S Tennstedt, E Ann Gormley; Urinary Incontinence Treatment Network
Collaborators, Affiliations
Randomized Controlled Trial

5-year continence rates, satisfaction and adverse events of burch urethropexy and fascial sling surgery for urinary incontinence

L Brubaker et al. J Urol. 2012 Apr.

Abstract

Purpose: We characterized continence, satisfaction and adverse events in women at least 5 years after Burch urethropexy or fascial sling with longitudinal followup of randomized clinical trial participants.

Materials and methods: Of 655 women who participated in a randomized surgical trial comparing the efficacy of the Burch and sling treatments 482 (73.6%) enrolled in this long-term observational study. Urinary continence status was assessed yearly for a minimum of 5 years postoperatively. Continence was defined as no urinary leakage on a 3-day voiding diary, and no self-reported stress incontinence symptoms and no stress incontinence surgical re-treatment.

Results: Incontinent participants were more likely to enroll in the followup study than continent patients (85.5% vs 52.2%) regardless of surgical group (p<0.0001). Overall the continence rates were lower in the Burch urethropexy group than in the fascial sling group (p=0.002). The continence rates at 5 years were 24.1% (95% CI 18.5 to 29.7) vs 30.8% (95% CI 24.7 to 36.9), respectively. Satisfaction at 5 years was related to continence status and was higher in women undergoing sling surgery (83% vs 73%, p=0.04). Satisfaction decreased with time (p=0.001) and remained higher in the sling group (p=0.03). The 2 groups had similar adverse event rates (Burch 10% vs sling 9%) and similar numbers of participants with adverse events (Burch 23 vs sling 22).

Conclusions: Continence rates in both groups decreased substantially during 5 years, yet most women reported satisfaction with their continence status. Satisfaction was higher in continent women and in those who underwent fascial sling surgery, despite the voiding dysfunction associated with this procedure.

Trial registration: ClinicalTrials.gov NCT00064662.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow of subjects through SISTEr and E-SISTEr
Figure 2
Figure 2
Continence rates over time
Figure 3
Figure 3
Proportion of patients reporting continence at 5 years by composite criteria and individual outcome components Note: Other therapy includes medical, device, behavior, and other.
Figure 4
Figure 4
The percentage of women who reported being satisfied with their urine leakage after surgery post op.
See this image and copyright information in PMC

References

    1. Rehman H, Bezerra CBC, Bruschini H, et al. Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database Syst Rev. 2011;1 - PubMed
    1. Ward K, Hilton P, United K, et al. Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ. 2002;325:67. - PMC - PubMed
    1. Sand PK, Winkler H, Blackhurst DW, et al. A prospective randomized study comparing modified Burch retropubic urethropexy and suburethral sling for treatment of genuine stress incontinence with low-pressure urethra. Am J Obstet Gynecol. 2000;182:30–34. - PubMed
    1. Novara G, Galfano A, Boscolo-Berto R, et al. Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol. 2008;53:288–308. - PubMed
    1. Tennstedt S Urinary Incontinence Treatment N. Design of the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr) Urol. 2005;66:1213–1217. - PubMed

Publication types

Associated data