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Complications in women undergoing Burch colposuspension versus autologous rectus fascial sling for stress urinary incontinence.
J Urol. 2009 May; 181(5):2192-7.JU

Abstract

PURPOSE

We determined the clinicodemographic factors associated with complications of continence procedures, the impact of concomitant surgery on the complication rate and the relationship between the incidence of cystitis and the method of postoperative bladder drainage.

MATERIALS AND METHODS

We reviewed serious adverse events and adverse events in the Stress Incontinence Surgical Efficacy Trial, a randomized trial comparing Burch colposuspension to the autologous rectus fascial sling. Clinicodemographic variables were analyzed to determine those associated with adverse events using logistic regression analysis. Complications were stratified based on the presence or absence of concomitant surgery. Differences in complication rates (controlling for concomitant surgery) and cystitis rates (controlling for the bladder emptying method) were compared using Fisher's exact test.

RESULTS

Blood loss (p = 0.0002) and operative time (p <0.0001) were significantly associated with an adverse event. Patients who underwent concomitant surgery had a significantly higher serious adverse event rate (14.2% vs 7.3%, p = 0.01) and adverse event rate (60.5% vs 48%, p <0.01) than patients who underwent continence surgery alone. Cystitis rates were higher in the sling vs the Burch group up to 6 weeks postoperatively regardless of concomitant surgery status (p <0.01). Intermittent self-catheterization increased the cystitis rate by 17% and 23% in the Burch and sling groups, respectively.

CONCLUSIONS

Concomitant surgery at continence surgery increased the risk of complications. Sling surgery was associated with a higher risk of cystitis within the first 6 weeks postoperatively. Intermittent self-catheterization increased the risk of cystitis in each group. Complications were associated with surgical factors and not with patient related factors.

Authors+Show Affiliations

Division of Urology, University of Maryland-Baltimore, Baltimore, Maryland 21201, USA. tchai@smail.umaryland.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19296969

Citation

Chai, Toby C., et al. "Complications in Women Undergoing Burch Colposuspension Versus Autologous Rectus Fascial Sling for Stress Urinary Incontinence." The Journal of Urology, vol. 181, no. 5, 2009, pp. 2192-7.
Chai TC, Albo ME, Richter HE, et al. Complications in women undergoing Burch colposuspension versus autologous rectus fascial sling for stress urinary incontinence. J Urol. 2009;181(5):2192-7.
Chai, T. C., Albo, M. E., Richter, H. E., Norton, P. A., Dandreo, K. J., Kenton, K., Lowder, J. L., & Stoddard, A. M. (2009). Complications in women undergoing Burch colposuspension versus autologous rectus fascial sling for stress urinary incontinence. The Journal of Urology, 181(5), 2192-7. https://doi.org/10.1016/j.juro.2009.01.019
Chai TC, et al. Complications in Women Undergoing Burch Colposuspension Versus Autologous Rectus Fascial Sling for Stress Urinary Incontinence. J Urol. 2009;181(5):2192-7. PubMed PMID: 19296969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complications in women undergoing Burch colposuspension versus autologous rectus fascial sling for stress urinary incontinence. AU - Chai,Toby C, AU - Albo,Michael E, AU - Richter,Holly E, AU - Norton,Peggy A, AU - Dandreo,Kimberly J, AU - Kenton,Kimberly, AU - Lowder,Jerry L, AU - Stoddard,Anne M, AU - ,, Y1 - 2009/03/17/ PY - 2008/08/11/received PY - 2009/3/20/entrez PY - 2009/3/20/pubmed PY - 2009/5/5/medline SP - 2192 EP - 7 JF - The Journal of urology JO - J Urol VL - 181 IS - 5 N2 - PURPOSE: We determined the clinicodemographic factors associated with complications of continence procedures, the impact of concomitant surgery on the complication rate and the relationship between the incidence of cystitis and the method of postoperative bladder drainage. MATERIALS AND METHODS: We reviewed serious adverse events and adverse events in the Stress Incontinence Surgical Efficacy Trial, a randomized trial comparing Burch colposuspension to the autologous rectus fascial sling. Clinicodemographic variables were analyzed to determine those associated with adverse events using logistic regression analysis. Complications were stratified based on the presence or absence of concomitant surgery. Differences in complication rates (controlling for concomitant surgery) and cystitis rates (controlling for the bladder emptying method) were compared using Fisher's exact test. RESULTS: Blood loss (p = 0.0002) and operative time (p <0.0001) were significantly associated with an adverse event. Patients who underwent concomitant surgery had a significantly higher serious adverse event rate (14.2% vs 7.3%, p = 0.01) and adverse event rate (60.5% vs 48%, p <0.01) than patients who underwent continence surgery alone. Cystitis rates were higher in the sling vs the Burch group up to 6 weeks postoperatively regardless of concomitant surgery status (p <0.01). Intermittent self-catheterization increased the cystitis rate by 17% and 23% in the Burch and sling groups, respectively. CONCLUSIONS: Concomitant surgery at continence surgery increased the risk of complications. Sling surgery was associated with a higher risk of cystitis within the first 6 weeks postoperatively. Intermittent self-catheterization increased the risk of cystitis in each group. Complications were associated with surgical factors and not with patient related factors. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19296969/Complications_in_women_undergoing_Burch_colposuspension_versus_autologous_rectus_fascial_sling_for_stress_urinary_incontinence_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2009.01.019?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -