Burch colposuspension: a 10-20 year follow up

Abstract

Objective: To review the outcome of women who underwent Burch colposuspension 10 to 20 years ago and to assess factors which affect long term success.

Design: Longitudinal retrospective study.

Setting: Urogynaecology Unit, St George's Hospital, London.

Subjects: One hundred and nine women with genuine stress incontinence.

Main outcome measures: Survival analysis of subjective and objective cure of stress incontinence.

Results: Cure of incontinence following Burch colposuspension is time-dependent, with a decline for 10 to 12 years when a plateau of 69% is reached. Factors adversely affecting cure are previous bladder neck surgery (logrank test P = 0.02), pre-operative weight greater than 80 kg, intra-operative blood loss more than 1000 ml and the development of post-operative detrusor instability. Post-operative complications included de novo detrusor instability (14.7%), long term complaints of voiding difficulty with objective recovery at the final follow up (22%) and recurrent urinary tract infection (4.6%).

Conclusions: Long term follow up after colposuspension is necessary to assess sequelae. We suggest that new continence procedures should be followed up for 5 to 10 years.