Colposuspension success and failure: a long-term objective follow-up study.
The Burch colposuspension is regarded as one of the most successful procedures for the operative treatment of genuine stress incontinence. In this study the authors have attempted to define long-term subjective and objective success rates. Of 121 patients operated on between 1985 and 1995, 83 were fully assessed: 77% (64/83) had no stress leakage, but 41% (34/83) were suffering from urge incontinence. On clinical assessment 6 cases of uterine prolapse or vault descent, 21 cystoceles (25%) and 47 rectoceles or rectoenteroceles (57%) were detected, all but 8 being asymptomatic. On ultrasound 64/83 patients (77%) had a normal result. Ten patients demonstrated bladder neck hypermobility and in 9 there was urethral funneling without hypermobility. Survival analysis showed that the likelihood of all types of failure and of abnormal ultrasound findings increased over time. It is proposed that long-term results after incontinence surgery be presented as survival analysis.
Dietz
H P
HP
Dunedin School of Medicine, University of Otago, New Zealand.
Wilson
P D
PD
D000328:Adult; D000368:Aged; D003127:Colposcopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014596:Uterine Prolapse