Bladder symptoms 1 year after abdominal sacrocolpopexy with and without Burch colposuspension in women without preoperative stress incontinence symptoms.
OBJECTIVE
The objective of the study was to examine changes in bladder symptoms 1 year after abdominal sacrocolpopexy (ASC) with vs without Burch colposuspension.


METHODS
Women without stress urinary incontinence (SUI) symptoms undergoing ASC were randomized to receive or not receive Burch. One year later, irritative, obstructive, and SUI symptoms were assessed in 305 women using Urogenital Distress Inventory subscales. A composite "stress endpoint" combined SUI symptoms, positive stress test, and retreatment.


RESULTS
In all women, the mean irritative score decreased from 19.6 +/- 16.3 (mean +/- SD) to 9.1 +/- 10.6; for obstructive symptoms, from 34.8 +/- 21.0 to 6.3 +/- 10.4 (both P < .001). Preoperative bothersome irritative symptoms resolved in 74.6% (126 of 169) and obstructive symptoms in 85.1% (212 of 249), independent of Burch. Fewer women with Burch had urge incontinence (14.5% vs 26.8%, P = .048) and fulfilled the stress endpoint (25.0% vs 40.1%, P = .012).


CONCLUSIONS
ASC reduced bothersome irritative and obstructive symptoms. Prophylactic Burch reduced stress and urge incontinence.
Burgio
Kathryn L
KL
Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA. kburgio@aging.uab.edu
Nygaard
Ingrid E
IE
Richter
Holly E
HE
Brubaker
Linda
L
Gutman
Robert E
RE
Leng
Wendy
W
Wei
John
J
Weber
Anne M
AM
D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D001745:Urinary Bladder Diseases / Q000209:etiology*; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control*; D014555:Urination Disorders / Q000209:etiology / Q000517:prevention & control*; D013519:Urogenital Surgical Procedures / Q000009:adverse effects*; D014596:Uterine Prolapse / Q000601:surgery*