Burch-Cooper's ligament sling procedure: an augmented incontinence operation.
OBJECTIVE
The Burch procedure is used in conjunction with a modified pubovesical sling to produce a potentially more durable incontinence operation. This augmented incontinence procedure is recommended for use in patients at particularly high risk of recurrence of incontinence or in patients with intrinsic sphincter deficiency who have concomitant cystocoele (paravaginal defect).


METHODS
A prospective study was initiated to demonstrate the efficacy of this combined operative procedure that incorporates two established operative techniques.


RESULTS
Ten of 13 patients in whom this operation was performed are completely continent. They have neither stress nor urgency incontinence. They have all resumed active lifestyles. Three patients experienced postoperative problems. They had complex presentations and/or required multiple operative procedures. Two women continue to have mild urge incontinence postoperatively. One of these women has occasional urinary retention. The third woman who had a large cystocele, intrinsic sphincter deficiency, and rectal prolapse has functional obstruction postoperatively.


CONCLUSIONS
Support and stability are developed at the urethrovesical angle by means of a combined operative procedure.
Dainer
M J
MJ
National Naval Medical Center and Walter Reed Army Medical Center, Bethesda, Maryland 20889, USA.
Zorn
B H
BH
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008022:Ligaments / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D013520:Urologic Surgical Procedures / Q000379:methods*