Burch Colposuspension Does Not Provide Any Additional Benefit to Pelvic Organ Prolapse Repair in Patients With Urinary Incontinence: A Randomized Surgical Trial

Abstract

We evaluated the impact of Burch colposuspension as an anti-incontinence measure in patients with urinary incontinence undergoing abdominal surgery for pelvic organ prolapse repair. A total of 47 women with pelvic organ prolapse and urinary incontinence were randomly assigned to abdominal pelvic organ prolapse repair and concomitant Burch colposuspension (24 patients, group A) or pelvic organ prolapse repair alone without an anti-incontinence procedure (23 patients, group B). They were followed up at 3, 6 and 9 months after surgery, and then annually. The primary outcome measures were anatomical outcome and changes in incontinence status as indicated by a bladder diary, the number of daily pads and the stress test. Secondary end points were changes in subjective symptoms and quality of life as measured by the Urogenital Distress Inventory and the Incontinence Impact Questionnaire. In group A 13 of 24 patients (54.2%) were still incontinent after surgery compared with 9 of 23 (39.1%) in group B. The intragroup difference was significant (group A p = 0.003, group B p = 0.0001), but there was no significant intergroup difference (p = 0.459 for A vs B). No significant intergroup difference emerged in anatomical outcome. Urogenital Distress Inventory and Incontinence Impact Questionnaire scores improved in both groups (p = 0.0001) but the intergroup difference was not significant in either questionnaire (p = 0.769 and p = 0.327, respectively). Burch colposuspension does not provide any additional benefit in pelvic organ prolapse repair in patients with urinary incontinence.