title: Tension free vaginal tape versus Burch colposuspension for treatment of female stress urinary incontinence.
abstract: BACKGROUND
  Many surgical procedures have been proposed for treatment of stress urinary incontinence (SUI) but none of them has proved completely successful. The aim of this study is to compare the efficacy and safety of tension free vaginal tape (TVT) with Burch colposuspension in the treatment of SIU.
  
  
  METHODS
  Fifty female patients, presenting with SUI were randomly divided into two equal groups. SUI was confirmed using urodynamic study in all patients. Group 1 (n=25) patients underwent Burch colposuspension while Group 2 (n=25) underwent TVT. Patients with high grade cystocele, previous surgical failure for SUI, uninhibited detrusor contraction during bladder filling on urodynamic study and incompetent internal sphincters were excluded from this study. A patient was declared cured of SUI, if 3-6 months after surgery she had no SUI. The procedure was judged to be a failure if 3-6 months after surgery, patient had SUI.
  
  
  RESULTS
  In group 1 patients, 72% were completely cured, 16% improved and 12% showed no improvement. In group 2 patients, 72 were completely cured, 20% improved and only 8% showed no improvement. There was no difference between the two groups in terms of cure rates. Operative time for TVT was significantly less compared to Burch. Postoperative pain was less in TVT than Burch. Return to normal activity was earlier in TVT compared to Burch group. Intra operative perforation of the urinary bladder occurred in 8% of patients in group 2. Urine retention occurred in 12% of patients in group 1 compared to 20% in group 2. This was successfully managed conservatively. De novo urgency developed in 12% in group I and 8% in group II and was successfully managed by medical treatment.
  
  
  CONCLUSIONS
  The success rates of TVT and Burch colposuspension in the treatment of SUI in our experience are very similar. However, TVT is associated with less morbidity. We recommend TVT procedure for females with genuine SUI.
authors.affiliation: Department of Surgery, Division of Urology, Faculty of Medicine, Mubarak Al-Kabeer Hospital, Kuwait University, Safat, Kuwait.
authors.forename: Ehab
authors.initials: E
authors.lastname: El-Barky
authors.forename: Ali
authors.initials: A
authors.lastname: El-Shazly
authors.forename: Osama Abdul
authors.initials: OA
authors.lastname: El-Wahab
authors.forename: Elijah O
authors.initials: EO
authors.lastname: Kehinde
authors.forename: Adel
authors.initials: A
authors.lastname: Al-Hunayan
authors.forename: Khaleel A
authors.initials: KA
authors.lastname: Al-Awadi
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D019736:Prostheses and Implants; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D014599:Uterus