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Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy: A Randomized Controlled Trial.
Obstet Gynecol. 2016 Oct; 128(4):828-35.OG

Abstract

OBJECTIVE

To compare efficacy and safety of retropubic Burch urethropexy and a midurethral sling in women with stress urinary incontinence (SUI) undergoing concomitant pelvic floor repair with sacrocolpopexy.

METHODS

Women were randomly assigned to Burch retropubic urethropexy (n=56) or retropubic midurethral sling (n=57) through dynamic allocation balancing age, body mass index, history of prior incontinence surgery, intrinsic sphincter deficiency, preoperative incontinence diagnosis, and prolapse stage. Overall and stress-specific continence primary outcomes were ascertained with validated questionnaires and a blinded cough stress test.

RESULTS

Enrollment was June 1, 2009, through August 31, 2013. At 6 months, no difference was found in overall (29 midurethral sling [51%] compared with 23 Burch [41%]; P=.30) (odds ratio [OR] 1.49, 95% confidence interval [CI] 0.71-3.13) or stress-specific continence rates (42 midurethral sling [74%] compared with 32 Burch [57%]; P=.06) (OR 2.10, 95% CI 0.95-4.64) between groups. However, the midurethral sling group reported greater satisfaction (78% compared with 57%; P=.04) and were more likely to report successful surgery for SUI (71% compared with 50%; P=.04) and to resolve pre-existing urgency incontinence (72% compared with 41%; P=.03). No difference was found in patient global impression of severity or symptom improvement, complication rates, or mesh exposures.

CONCLUSION

There was no difference in overall or stress-specific continence rates between midurethral sling and Burch urethropexy groups at 6 months. However, the midurethral sling group reported better patient-centered secondary outcomes.

Authors+Show Affiliations

Divisions of Gynecologic Surgery and Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota; and the Department of Obstetrics and Gynecology, University of Missouri, Kansas City, Missouri.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27607858

Citation

Trabuco, Emanuel C., et al. "Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy: a Randomized Controlled Trial." Obstetrics and Gynecology, vol. 128, no. 4, 2016, pp. 828-35.
Trabuco EC, Klingele CJ, Blandon RE, et al. Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy: A Randomized Controlled Trial. Obstet Gynecol. 2016;128(4):828-35.
Trabuco, E. C., Klingele, C. J., Blandon, R. E., Occhino, J. A., Weaver, A. L., McGree, M. E., Lemens, M. A., & Gebhart, J. B. (2016). Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy: A Randomized Controlled Trial. Obstetrics and Gynecology, 128(4), 828-35. https://doi.org/10.1097/AOG.0000000000001651
Trabuco EC, et al. Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy: a Randomized Controlled Trial. Obstet Gynecol. 2016;128(4):828-35. PubMed PMID: 27607858.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy: A Randomized Controlled Trial. AU - Trabuco,Emanuel C, AU - Klingele,Christopher J, AU - Blandon,Roberta E, AU - Occhino,John A, AU - Weaver,Amy L, AU - McGree,Michaela E, AU - Lemens,Maureen A, AU - Gebhart,John B, PY - 2016/9/9/entrez PY - 2016/9/9/pubmed PY - 2017/5/24/medline SP - 828 EP - 35 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 128 IS - 4 N2 - OBJECTIVE: To compare efficacy and safety of retropubic Burch urethropexy and a midurethral sling in women with stress urinary incontinence (SUI) undergoing concomitant pelvic floor repair with sacrocolpopexy. METHODS: Women were randomly assigned to Burch retropubic urethropexy (n=56) or retropubic midurethral sling (n=57) through dynamic allocation balancing age, body mass index, history of prior incontinence surgery, intrinsic sphincter deficiency, preoperative incontinence diagnosis, and prolapse stage. Overall and stress-specific continence primary outcomes were ascertained with validated questionnaires and a blinded cough stress test. RESULTS: Enrollment was June 1, 2009, through August 31, 2013. At 6 months, no difference was found in overall (29 midurethral sling [51%] compared with 23 Burch [41%]; P=.30) (odds ratio [OR] 1.49, 95% confidence interval [CI] 0.71-3.13) or stress-specific continence rates (42 midurethral sling [74%] compared with 32 Burch [57%]; P=.06) (OR 2.10, 95% CI 0.95-4.64) between groups. However, the midurethral sling group reported greater satisfaction (78% compared with 57%; P=.04) and were more likely to report successful surgery for SUI (71% compared with 50%; P=.04) and to resolve pre-existing urgency incontinence (72% compared with 41%; P=.03). No difference was found in patient global impression of severity or symptom improvement, complication rates, or mesh exposures. CONCLUSION: There was no difference in overall or stress-specific continence rates between midurethral sling and Burch urethropexy groups at 6 months. However, the midurethral sling group reported better patient-centered secondary outcomes. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/27607858/Burch_Retropubic_Urethropexy_Compared_With_Midurethral_Sling_With_Concurrent_Sacrocolpopexy:_A_Randomized_Controlled_Trial_ L2 - https://doi.org/10.1097/AOG.0000000000001651 DB - PRIME DP - Unbound Medicine ER -