title: A prospective randomized study comparing modified Burch retropubic urethropexy and suburethral sling for treatment of genuine stress incontinence with low-pressure urethra.
abstract: OBJECTIVE
  The aim of this study was to compare a modified Burch procedure with a suburethral sling for the treatment of stress incontinence complicated by a low-pressure urethra.
  
  
  METHODS
  Thirty-six women with stress incontinence, low-pressure urethra, and urethral hypermobility (straining cotton swab angle >/=30 degrees ) were randomly assigned to undergo either a modified Burch procedure (n = 19) or a suburethral sling (n = 17). Objective and subjective cure rates at 3 months after the operation were the primary outcome measures. Comparisons of group means were performed with the Student t test for independent groups, and proportions were compared with the Fisher exact test.
  
  
  RESULTS
  After the operation the 2 groups had statistically similar cure rates and voiding function. Urethral closure pressure, pressure transmission ratios, and maximum detrusor pressure during voiding were significantly higher in the sling group.
  
  
  CONCLUSIONS
  At 3 months there were no clinically significant differences between the groups treated with suburethral sling and modified Burch procedures.
authors.affiliation: Evanston Continence Center, Evanston Hospital, Northwestern University Medical School, IL, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Sand
authors.forename: H
authors.initials: H
authors.lastname: Winkler
authors.forename: D W
authors.initials: DW
authors.lastname: Blackhurst
authors.forename: P J
authors.initials: PJ
authors.lastname: Culligan
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology; D011182:Postoperative Care; D011183:Postoperative Complications; D011312:Pressure; D011446:Prospective Studies; D014521:Urethra / Q000503:physiopathology* / Q000601:surgery*; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention