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[Does a Combined Fascial Sling - Burch Colposuspension Display Advantages over a Fascial Sling alone for Treatment of Urinary Stress Incontinence in Females?].
Aktuelle Urol. 2003 May; 34(3):166-71.AU

Abstract

PURPOSE

Despite the development of new surgical techniques, the fascial sling procedure remains an important surgical technique for the treatment of female urinary stress incontinence. An advantage of combining it with an additional Burch colposuspension has been suggested. The objective of our study was to evaluate retrospectively selected patients who had undergone a fascial sling procedure with and without Burch colposuspension.

MATERIALS AND METHODS

Of a total of 390 females who underwent an incontinence operation at our department between 1990 and 1999, 56 patients had had a fascial sling plasty. A total of 50 patients (89 %) were followed for a median of 59.5 months. The median age was 60 years. 56 % of the patients displayed recurrent stress incontinence. The previous operations had been performed via a vaginal approach in 42.9 % and an abdominal approach in 57.1 %. The sling procedure used was that of Narik and Palmrich. Of the 50 patients, 14 had an additional Burch colposuspension.

RESULTS

The continence rates (no pads) were for patients with a fascial sling procedure alone 63.9 % and for the combination of both operations 64.4 %. An improvement (1-3 pads) was seen in 27.8 % and 21.4 %, respectively. No changes were seen in 5.6 % and 7.1 % and impairment was seen in 2.7 % and 7.1 %, respectively. After a five-year follow-up, the total patient satisfaction rate was 78 %.

CONCLUSIONS

The fascial sling is effective operative technique for treating female urinary stress incontinence, especially in severe and type III incontinence and in patients who had undergone previous operations for incontinence. The operation is safe and is the only technique that offers controlled overcorrection in desperate cases. An advantage of adding a Burch colposuspension to the fascial sling procedure was not detected in our patient group.

Authors+Show Affiliations

Urologische Klinik und Poliklinik, Johannes-Gutenberg-Universität Mainz, Germany. jpfitz@gmx.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

ger

PubMed ID

14566688

Citation

Pfitzenmaier, J, et al. "[Does a Combined Fascial Sling - Burch Colposuspension Display Advantages Over a Fascial Sling Alone for Treatment of Urinary Stress Incontinence in Females?]." Aktuelle Urologie, vol. 34, no. 3, 2003, pp. 166-71.
Pfitzenmaier J, Gilfrich C, Faldum A, et al. [Does a Combined Fascial Sling - Burch Colposuspension Display Advantages over a Fascial Sling alone for Treatment of Urinary Stress Incontinence in Females?]. Aktuelle Urol. 2003;34(3):166-71.
Pfitzenmaier, J., Gilfrich, C., Faldum, A., Müller, M., Hohenfellner, M., & Thüroff, J. W. (2003). [Does a Combined Fascial Sling - Burch Colposuspension Display Advantages over a Fascial Sling alone for Treatment of Urinary Stress Incontinence in Females?]. Aktuelle Urologie, 34(3), 166-71.
Pfitzenmaier J, et al. [Does a Combined Fascial Sling - Burch Colposuspension Display Advantages Over a Fascial Sling Alone for Treatment of Urinary Stress Incontinence in Females?]. Aktuelle Urol. 2003;34(3):166-71. PubMed PMID: 14566688.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Does a Combined Fascial Sling - Burch Colposuspension Display Advantages over a Fascial Sling alone for Treatment of Urinary Stress Incontinence in Females?]. AU - Pfitzenmaier,J, AU - Gilfrich,C, AU - Faldum,A, AU - Müller,M, AU - Hohenfellner,M, AU - Thüroff,J W, PY - 2003/10/21/pubmed PY - 2003/12/20/medline PY - 2003/10/21/entrez SP - 166 EP - 71 JF - Aktuelle Urologie JO - Aktuelle Urol VL - 34 IS - 3 N2 - PURPOSE: Despite the development of new surgical techniques, the fascial sling procedure remains an important surgical technique for the treatment of female urinary stress incontinence. An advantage of combining it with an additional Burch colposuspension has been suggested. The objective of our study was to evaluate retrospectively selected patients who had undergone a fascial sling procedure with and without Burch colposuspension. MATERIALS AND METHODS: Of a total of 390 females who underwent an incontinence operation at our department between 1990 and 1999, 56 patients had had a fascial sling plasty. A total of 50 patients (89 %) were followed for a median of 59.5 months. The median age was 60 years. 56 % of the patients displayed recurrent stress incontinence. The previous operations had been performed via a vaginal approach in 42.9 % and an abdominal approach in 57.1 %. The sling procedure used was that of Narik and Palmrich. Of the 50 patients, 14 had an additional Burch colposuspension. RESULTS: The continence rates (no pads) were for patients with a fascial sling procedure alone 63.9 % and for the combination of both operations 64.4 %. An improvement (1-3 pads) was seen in 27.8 % and 21.4 %, respectively. No changes were seen in 5.6 % and 7.1 % and impairment was seen in 2.7 % and 7.1 %, respectively. After a five-year follow-up, the total patient satisfaction rate was 78 %. CONCLUSIONS: The fascial sling is effective operative technique for treating female urinary stress incontinence, especially in severe and type III incontinence and in patients who had undergone previous operations for incontinence. The operation is safe and is the only technique that offers controlled overcorrection in desperate cases. An advantage of adding a Burch colposuspension to the fascial sling procedure was not detected in our patient group. SN - 0001-7868 UR - https://www.unboundmedicine.com/medline/citation/14566688/[Does_a_Combined_Fascial_Sling___Burch_Colposuspension_Display_Advantages_over_a_Fascial_Sling_alone_for_Treatment_of_Urinary_Stress_Incontinence_in_Females]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2003-40233 DB - PRIME DP - Unbound Medicine ER -