Burch colposuspension versus stamey endoscopic bladder neck suspension: a urodynamic appraisal.
A total of 51 consecutive female patients with genuine stress incontinence who underwent a Burch or Stamey operation were clinically and urodynamically evaluated preoperatively at least 8 months postoperatively. Our study group consisted of 27 women who underwent the Burch colposuspension and 24 who had the Stamey endoscopic bladder neck suspension. The urodynamic parameters which were studied pre- and postoperatively were the maximum flow rate (Qmax), the residual urine (Vres), the first sensation (FS), the bladder capacity (BC), the maximum vesical pressure (Pves max), the detrusor pressure at maximum flow (Pdet/Qmax), the functional urethral length (Lfun) and the maximum closure pressure (Pclos max). The successful results of the operations were 89% for Burch and 83% for the Stamey procedure. As for differing objective urodynamic findings, the Qmax, Pclos max, Vres and Lfun for both groups were the only parameters which showed statistically significant difference after surgery. The statistical comparison of the postoperative urodynamic parameters of the two operative techniques showed that Lfun, Pves max and Pclos max had difference in favor of Burch colposuspension. There were not statistical differences in the other studied parameters. In conclusion, according to the differentiation in the values of Pclos max, Lfun and Pves max, the Burch technique seems to result in a higher increase of patient's urethral resistance.
Athanassopoulos
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Department of Urology, School of Medicine, University of Patras, Greece.
Barbalias
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D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D011897:Random Allocation; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology*