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A randomised trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence.
BJOG. 2004 Sep; 111(9):974-81.BJOG

Abstract

OBJECTIVE

To compare open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence.

DESIGN

Multicentre, prospective randomised trial.

SETTING

Departments of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Borås County Hospital and Orebro University Hospital, Sweden.

POPULATION

Women with genuine stress urinary incontinence or mixed incontinence with a predominantly stress component were included, and were randomised to either open colposuspension (n= 120) or laparoscopic colposuspension (n= 120).

METHODS

Women were randomised to open colposuspension with sutures or laparoscopic colposuspension with polypropylene mesh and staples. Anaesthesia/operation time, blood loss, complications and other related surgical parameters were compared.

MAIN OUTCOME MEASURES

Objective and subjective cure rates from 48-hour frequency-volume chart, a 48-hour pad test and a subjective assessment of the woman's incontinence and quality of life performed one year after surgery.

RESULTS

Objective and subjective cure rates were higher after open compared with laparoscopic colposuspension (P < 0.001). Quality of life was improved following surgery in both groups (P < 0.0001) and the improvement was significantly greater in the open colposuspension group (P < 0.05) with regard to physical activity. Performing an open colposuspension was less time consuming (P < 0.0001), resulted in more blood loss (P < 0.0001), longer catheterisation time (P < 0.01), greater risk of urinary retention (P < 0.01) and a longer hospital stay (P < 0.0001) compared with performing a laparoscopic colposuspension. The rate of serious complications was low in both groups.

CONCLUSION

Open colposuspension had a higher objective and subjective cure rate one year after surgery but with a greater blood loss, greater risk of urinary retention and a longer hospital stay than laparoscopic colposuspension.

Authors+Show Affiliations

Ankardal M
Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
Ekerydh A
No affiliation info available
Crafoord K
No affiliation info available
Milsom I
No affiliation info available
Stjerndahl JH
No affiliation info available
Engh ME
No affiliation info available

MeSH

AdultColpotomyFemaleHumansLaparoscopySurgical MeshSurgical StaplingSuture TechniquesTreatment OutcomeUrinary Incontinence, Stress

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15327613

Citation

Ankardal, Maud, et al. "A Randomised Trial Comparing Open Burch Colposuspension Using Sutures With Laparoscopic Colposuspension Using Mesh and Staples in Women With Stress Urinary Incontinence." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 111, no. 9, 2004, pp. 974-81.
Ankardal M, Ekerydh A, Crafoord K, et al. A randomised trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence. BJOG. 2004;111(9):974-81.
Ankardal, M., Ekerydh, A., Crafoord, K., Milsom, I., Stjerndahl, J. H., & Engh, M. E. (2004). A randomised trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence. BJOG : an International Journal of Obstetrics and Gynaecology, 111(9), 974-81.
Ankardal M, et al. A Randomised Trial Comparing Open Burch Colposuspension Using Sutures With Laparoscopic Colposuspension Using Mesh and Staples in Women With Stress Urinary Incontinence. BJOG. 2004;111(9):974-81. PubMed PMID: 15327613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomised trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence. AU - Ankardal,Maud, AU - Ekerydh,Anne, AU - Crafoord,Kristina, AU - Milsom,Ian, AU - Stjerndahl,Jan-Henrik, AU - Engh,Marie Ellström, PY - 2004/8/26/pubmed PY - 2004/10/13/medline PY - 2004/8/26/entrez SP - 974 EP - 81 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 111 IS - 9 N2 - OBJECTIVE: To compare open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence. DESIGN: Multicentre, prospective randomised trial. SETTING: Departments of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Borås County Hospital and Orebro University Hospital, Sweden. POPULATION: Women with genuine stress urinary incontinence or mixed incontinence with a predominantly stress component were included, and were randomised to either open colposuspension (n= 120) or laparoscopic colposuspension (n= 120). METHODS: Women were randomised to open colposuspension with sutures or laparoscopic colposuspension with polypropylene mesh and staples. Anaesthesia/operation time, blood loss, complications and other related surgical parameters were compared. MAIN OUTCOME MEASURES: Objective and subjective cure rates from 48-hour frequency-volume chart, a 48-hour pad test and a subjective assessment of the woman's incontinence and quality of life performed one year after surgery. RESULTS: Objective and subjective cure rates were higher after open compared with laparoscopic colposuspension (P < 0.001). Quality of life was improved following surgery in both groups (P < 0.0001) and the improvement was significantly greater in the open colposuspension group (P < 0.05) with regard to physical activity. Performing an open colposuspension was less time consuming (P < 0.0001), resulted in more blood loss (P < 0.0001), longer catheterisation time (P < 0.01), greater risk of urinary retention (P < 0.01) and a longer hospital stay (P < 0.0001) compared with performing a laparoscopic colposuspension. The rate of serious complications was low in both groups. CONCLUSION: Open colposuspension had a higher objective and subjective cure rate one year after surgery but with a greater blood loss, greater risk of urinary retention and a longer hospital stay than laparoscopic colposuspension. SN - 1470-0328 UR - https://www.unboundmedicine.com/medline/citation/15327613/A_randomised_trial_comparing_open_Burch_colposuspension_using_sutures_with_laparoscopic_colposuspension_using_mesh_and_staples_in_women_with_stress_urinary_incontinence_ DB - PRIME DP - Unbound Medicine ER -