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Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence.
Obstet Gynecol. 2008 07; 112(1):49-55.OG

Abstract

OBJECTIVES

To report anatomic and functional outcomes 2 years after sacrocolpopexy in stress-continent women with or without prophylactic Burch colposuspension.

METHODS

In the Colpopexy and Urinary Reduction Efforts (CARE) trial, stress-continent women undergoing sacrocolpopexy were randomized to receive or not receive a Burch colposuspension. Outcomes included urinary symptoms, other pelvic symptoms, and pelvic support. Standardized pelvic organ prolapse quantification examinations and validated outcome measures including the Pelvic Floor Distress Inventory and the Pelvic Floor Impact Questionnaire were completed before surgery and at several postoperative intervals, including at 2 years.

RESULTS

This analysis is based on 322 randomized participants; certain analyses were done with a subset based on data availability. Most were Caucasian (94%), with a mean age of 62±10 years (mean±standard deviation). Two years after surgery, 41.8% and 57.9% of women in the Burch and control groups, respectively, met the stress incontinence endpoint (presence of symptoms or positive cough stress test or interval treatment for stress incontinence, P=.020). The apex was well supported (point C within 2 cm of total vaginal length) in 95% of women, and this was not affected by concomitant Burch (P=.18). There was a trend toward fewer urgency symptoms in the Burch group (32.0% versus 44.5% no Burch, P=.085). Twenty participants experienced mesh or suture erosions.

CONCLUSION

The early advantage of prophylactic Burch colposuspension for stress incontinence that was seen at 3 months remains at 2 years. Apical anatomic success rates are high and not affected by concomitant Burch.

CLINICAL TRIAL REGISTRATION

(www.clinicaltrials.gov), ClinicalTrials.gov, NCT00065845.

LEVEL OF EVIDENCE

I.

Links

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Authors+Show Affiliations

Brubaker L
Department of Obstetrics and Gynecology and Urology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, USA. Lbrubaker@lumc.edu
Nygaard I
No affiliation info available
Richter HE
No affiliation info available
Visco A
No affiliation info available
Weber AM
No affiliation info available
Cundiff GW
No affiliation info available
Fine P
No affiliation info available
Ghetti C
No affiliation info available
Brown MB
No affiliation info available

MeSH

AgedFemaleFollow-Up StudiesGynecologic Surgical ProceduresHumansMiddle AgedQuality of LifeSuburethral SlingsTreatment OutcomeUrinary Incontinence, StressUrologic Surgical ProceduresUterine Prolapse

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18591307

Clinical Trial Links

Clinical trial which this article describes
Advanced Genital Prolapse Surgery With and Without Mid Urethral Sling to Prevent Stress Urinary Incontinence

Citation

Brubaker, Linda, et al. "Two-year Outcomes After Sacrocolpopexy With and Without Burch to Prevent Stress Urinary Incontinence." Obstetrics and Gynecology, vol. 112, no. 1, 2008, pp. 49-55.
Brubaker L, Nygaard I, Richter HE, et al. Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence. Obstet Gynecol. 2008;112(1):49-55.
Brubaker, L., Nygaard, I., Richter, H. E., Visco, A., Weber, A. M., Cundiff, G. W., Fine, P., Ghetti, C., & Brown, M. B. (2008). Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence. Obstetrics and Gynecology, 112(1), 49-55. https://doi.org/10.1097/AOG.0b013e3181778d2a
Brubaker L, et al. Two-year Outcomes After Sacrocolpopexy With and Without Burch to Prevent Stress Urinary Incontinence. Obstet Gynecol. 2008;112(1):49-55. PubMed PMID: 18591307.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence. AU - Brubaker,Linda, AU - Nygaard,Ingrid, AU - Richter,Holly E, AU - Visco,Anthony, AU - Weber,Anne M, AU - Cundiff,Geoffrey W, AU - Fine,Paul, AU - Ghetti,Chiara, AU - Brown,Morton B, PY - 2008/7/2/pubmed PY - 2008/8/6/medline PY - 2008/7/2/entrez SP - 49 EP - 55 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 112 IS - 1 N2 - OBJECTIVES: To report anatomic and functional outcomes 2 years after sacrocolpopexy in stress-continent women with or without prophylactic Burch colposuspension. METHODS: In the Colpopexy and Urinary Reduction Efforts (CARE) trial, stress-continent women undergoing sacrocolpopexy were randomized to receive or not receive a Burch colposuspension. Outcomes included urinary symptoms, other pelvic symptoms, and pelvic support. Standardized pelvic organ prolapse quantification examinations and validated outcome measures including the Pelvic Floor Distress Inventory and the Pelvic Floor Impact Questionnaire were completed before surgery and at several postoperative intervals, including at 2 years. RESULTS: This analysis is based on 322 randomized participants; certain analyses were done with a subset based on data availability. Most were Caucasian (94%), with a mean age of 62±10 years (mean±standard deviation). Two years after surgery, 41.8% and 57.9% of women in the Burch and control groups, respectively, met the stress incontinence endpoint (presence of symptoms or positive cough stress test or interval treatment for stress incontinence, P=.020). The apex was well supported (point C within 2 cm of total vaginal length) in 95% of women, and this was not affected by concomitant Burch (P=.18). There was a trend toward fewer urgency symptoms in the Burch group (32.0% versus 44.5% no Burch, P=.085). Twenty participants experienced mesh or suture erosions. CONCLUSION: The early advantage of prophylactic Burch colposuspension for stress incontinence that was seen at 3 months remains at 2 years. Apical anatomic success rates are high and not affected by concomitant Burch. CLINICAL TRIAL REGISTRATION: (www.clinicaltrials.gov), ClinicalTrials.gov, NCT00065845. LEVEL OF EVIDENCE: I. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/18591307/Two_year_outcomes_after_sacrocolpopexy_with_and_without_burch_to_prevent_stress_urinary_incontinence_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=18591307.ui DB - PRIME DP - Unbound Medicine ER -