Burch Colposuspension versus Fascial Sling to Reduce Urinary Stress Incontinence

Albo, Michael; Richter, Holly E.; Brubaker, Linda; Norton, Peggy; Kraus, Stephen R.; Chai, Toby C.; Zyczynski, Halina M.; Diokno, Ananias C.; Tennstedt, Sharon L.; Nager, Charles W.; Lloyd, L. Keith; FitzGerald, MaryPat; Lemack, Gary E.; Johnson, Harry G.; Leng, Wendy W.J. de; Mallett, Veronica; Stoddard, Anne M.; Menefee, Shawn A.; Varner, R. Edward; Kenton, Kimberly; Moalli, Pam; Sirls, Larry; Dandreo, Kimberly J.; Kusek, John W.; Nyberg, Leroy M.; Steers, William D.

doi:10.1056/nejmoa070416

Cited by 442 publications

(259 citation statements)

References 35 publications

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“…In one of the landmark trials, Lemack et al reported that the valsalva leak point pressure (VLPP) did not correlate with incontinence severity [19]. This finding is supported by data from the Mid-Urethral Slings (TOMUS) trial which showed that VLPP did not affect the surgery outcome [20].…”

Section: Urine Incontinencesupporting

confidence: 73%

Role of Urodynamics in the Evaluation of Elderly Voiding Dysfunction

Mahdy

Ghoniem

2014

Curr Bladder Dysfunct Rep

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Voiding dysfunction is a common condition in the elderly that can affect both men and women. Due to the ageassociated changes in the lower urinary tract, voiding dysfunction in the elderly is usually complex and multifactorial, necessitating more objective testing sometimes. In this chapter, we will focus on the role of urodynamics in the setting of voiding dysfunction in the elderly. The term voiding dysfunction will be used to refer both to storage and obstructive lower urinary tract symptoms.

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Section: Urine Incontinencesupporting

confidence: 73%

Role of Urodynamics in the Evaluation of Elderly Voiding Dysfunction

Mahdy

Ghoniem

2014

Curr Bladder Dysfunct Rep

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“…The lower continence rates observed in ESISTEr are likely related to our use of a composite, unidirectional definition of continence. We and others have shown that composite endpoints are associated with lower continence rates 6 . The traditional elements in the composite endpoints do not allow for meaningful clinical improvement in symptoms.…”

Section: Discussionmentioning

confidence: 99%

172 Five year continence rates, satisfaction and adverse events of Burch urethropexy and fascial sling surgery for urinary incontinence

Brubaker¹

2012

European Urology Supplements

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Purpose-To characterize continence, satisfaction, and adverse events in women at least 5 years after a Burch urethropexy or fascial sling with longitudinal follow-up of randomized clinical trial participants at least 5 years post-operatively.Methods-482 (73.6520 (79.4%) of 655 women participated in a randomized surgical trial comparing efficacy of the Burch and sling treatments enrolled in this long-term observational study. Urinary continence status was assessed yearly for a minimum of five years postoperatively. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptContinence was defined as no urinary leakage on a three-day voiding diary and no self-reported stress incontinence symptoms AND no stress incontinence surgical retreatment.Results-Incontinent participants were more likely to enroll in the follow-up 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 five years were 24.1% (95% CI 18.5% to 29.7%) compared to 30.8% (24.7% to 36.9%), respectively.Satisfaction at 5 years was related to continence status and higher in women undergoing a sling (83% vs. 73%, p=0.04). Satisfaction declined over time (P=0.001) and remained higher in the sling group (p=0.03). The two groups had similar adverse event rates (10% Burch vs.9 % sling) and similar numbers of participants with adverse events (23 Burch vs. 22 sling).Conclusions-Continence rates in both groups declined substantially over five years, yet most women reported satisfaction with their continence status. Satisfaction was higher in continent women and those who underwent fascial sling, despite the voiding dysfunction associated with this procedure.

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“…The higher rate of UTIs in the mesh group was likely associated with the higher rates of retention and associated catheterizations, both known to predispose patients to UTIs. [25][26][27] Mesh placement was associated with higher rates of UTIs, regardless of concomitant sling placement. A UTI diagnosis appearing in a Medicare claim may or may not be culture-proven.…”

Section: Commentmentioning

confidence: 99%

1544 Short-Term Outcomes of Vaginal Mesh Placement Among Female Medicare Beneficiaries

Anger¹,

Khan²,

Eilber³

et al. 2012

Journal of Urology

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Objectives-To compare short-term outcomes between prolapse repairs with and without mesh using a national dataset. Mesh use in surgical treatment of pelvic organ prolapse (POP) has gained wide popularity. However, mesh complications have increased concomitantly with its use. Methods-PublicUse File data were obtained for a 5% random national sample of female Medicare beneficiaries age 65 and over. Women who underwent prolapse surgery were identified by CPT-4 codes. Since the code for mesh placement was effected in 2005, we separated patients into three cohorts: those who underwent prolapse repairs from 1999-2000 (presumably without mesh), those who underwent repairs in 2007-2008 (presumably without mesh), and those with mesh (based on CPT-4 code 57267) in [2007][2008]. One-year outcomes were identified using ICD-9 diagnosis and procedure codes and CPT-4 procedure codes. Results DisclosuresKaryn S. Eilber is a speaker for Astellas; an investigator and consultant for American Medical Systems; and an investigator for Boston Scientific. J. Quentin Clemens is a consultant for Medtronic, Afferent Pharmaceuticals, and Amphora Medical; a speaker for Endo Pharmaceuticals; involved in trial participation with Taris; and a meeting participant with Allergen. All other authors report no conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. vs. 4%, p < 0.02). Mesh removal rates were higher in mesh vs. non-mesh group (4% vs. 0-1%, p < 0.001). Mesh use was associated with more dyspareunia, mesh-related complications, and urinary retention, even when controlling for concomitant sling. NIH Public AccessConclusions-Mesh to treat POP and stress urinary incontinence (SUI) was associated with a small decrease in early re-operation for prolapse. This decrease came at the expense of increased rates of pelvic pain, retention, mesh-related complications, and mesh removal.

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Burch Colposuspension versus Fascial Sling to Reduce Urinary Stress Incontinence

Abstract: The autologous fascial sling results in a higher rate of successful treatment of stress incontinence but also greater morbidity than the Burch colposuspension. (ClinicalTrials.gov number, NCT00064662 [ClinicalTrials.gov] .).

Cited by 442 publications

References 35 publications

Role of Urodynamics in the Evaluation of Elderly Voiding Dysfunction

Role of Urodynamics in the Evaluation of Elderly Voiding Dysfunction

172 Five year continence rates, satisfaction and adverse events of Burch urethropexy and fascial sling surgery for urinary incontinence

1544 Short-Term Outcomes of Vaginal Mesh Placement Among Female Medicare Beneficiaries

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