The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country

Abstract

Objectives: To compare the effectiveness and complications of Burch colposuspension and Mid Urethral Slings (MUS) for the treatment of Stress Urinary Incontinence (SUI).
 Methods: We conducted a cross-sectional study of 162 patients who underwent surgery for SUI with Burch colposuspension (n=40), tension free vaginal tape (TVT) (n= 59) or transobturator tape (TOT) (n=63), from 2006 to 2014 at the Aga Khan University Hospital- Karachi. All three groups were assessed in terms of demographics, cure rates, intraoperative and postoperative complications at one and five years using incontinence impact questionnaire-short form-7 (IIQ-7) and urogenital distress inventory -short form-6 (UDI-6).
 Results: Mean age of the participants in Burch, TVT and TOT group was 44.1 ± 7.4, 48.3 ± 8.9, 53.0 ± 9.4 respectively. Majority of patients in TVT group were premenopausal (59.3%) and postmenopausal in TOT group (53.9%). Most abdominal hysterectomies were done in Burch group (40) while vaginal hysterectomies and anterior and posterior colporrhaphy in TOT group (55). All the procedures had both subjective and objective cure rate of more than 82% at one year, with TVT having the highest success rate of 96.61%. The objective cure rate in Burch, TVT and TOT group at five years was 74.19%, 90.30% and 81.25% respectively. Intraoperative complications included hemorrhage in one patient during Burch procedure and bladder perforation in two cases of TVT, with no significant difference in short or long-term complications with either procedure.
 Conclusions: All the three procedures have equal efficacy and complication rates. Even though TVT is the new gold standard but in view of current debate regarding mesh related complications, there is a need to readdress Burch colposuspension for treatment of SUI.
 doi: https://doi.org/10.12669/pjms.37.5.4017
 How to cite this:Abrar S, Razzak L, Mohsin R. The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4017
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Safety and efficacy of surgical transobturator tape in the treatment of stress urinary incontinence in women - three years of follow-up

“…However, there are still complications, and the most common intraoperative complications are bladder and vaginal perforations and hemorrhage [10]. There were no significant intraoperative complications in our study, as evidenced by Abrar et al [18] who conducted a cross-sectional study of 162 patients who underwent surgery for SUI with Burch colposuspension (n = 40), tension free vaginal tape (TVT) (n = 59) or TOT (n = 63), from 2006 to 2014 at the Aga Khan University Hospital in Karachi.…”

Exploring the Challenges of Using Minimal Invasive Surgery to Treat Stress Urinary Incontinence: Insights from a Retrospective Case-Control Study

“…This research offers clinical proof that supports the TVT method, suggesting it provides a similar level of efficacy to open colposuspension, but without entailing the complications associated with open surgery. More recent studies, conducted by Saida Abrar et al across eight years, show that although TVT is considered to be the gold standard in many respects, surgeons must remember that colposuspension remains a valuable surgical technique, often offering more than satisfactory efficacy [24]. Moreover, low-tension suburethral bands have their own complications, such as urinary retention, de novo detrusor instability, infection and erosion, chronic pelvic pain, dyspareunia, which can all persist in the long term [25,26].…”

Comparison of laparoscopic versus open Burch colposuspension techniques for female stress or mixed urinary incontinence: a ten-year experience in a tertiary center

“…3 Most published studies compared BC with other surgical procedures for SUI, showing diverse conclusions regarding subjective cure rates on the long-term follow-up period. 11,12,17, 19 A systematic review and meta-analysis comparing data from different SUI procedures showed that in long-term followup, MUS and BC have equal subjective continence rates. 20 We found similar postoperative subjective cure rates at the first month, the sixth month, and 1st year, similar to Fusco et al 20 However, preoperative UDI-6 scores were higher in the open BC group.…”