title: Pelvic organ prolapse repair with and without prophylactic concomitant Burch colposuspension in continent women: a randomized, controlled trial with 8-year followup.
abstract: OBJECTIVE
  We reevaluated and brought up to date the 8-year followup of a previous published, randomized, controlled trial of the impact of Burch colposuspension as a prophylactic anti-incontinence procedure in patients without urinary incontinence who underwent abdominal pelvic organ prolapse repair.
  
  
  METHODS
  A total of 66 continent women with pelvic organ prolapse were randomly assigned to abdominal pelvic organ prolapse repair and concomitant Burch colposuspension in 34 (group 1) or pelvic organ prolapse repair alone without an anti-incontinence procedure in 32 (group 2). Primary study end points were the anatomical outcome and changes in incontinence status. Secondary end points were changes in subjective symptoms and quality of life.
  
  
  RESULTS
  Median followup was 97 months (range 72 to 134). Three group 1 and 1 group 2 patients were lost to followup. Three group 1 patients had a stage I rectocele and 1 had a stage I cystocele. Four group 2 patients had a stage I rectocele and 3 had a stage I cystocele. Nine of 31 group 1 patients (29%) were incontinent compared with 5 of 31 (16%) in group 2 (p = 0.553). In group 1 all except 1 patient were successfully treated for voiding dysfunction. Storage symptoms had disappeared in 1 patient and de novo storage symptoms had developed in 2 since the previous followup. De novo incontinence developed in 2 group 2 patients after midterm outcomes were reported. Median Urogenital Distress Inventory-6 and Incontinence Impact on Quality of Life-7 scores were improved in all groups at last followup (p 0.0001).
  
  
  CONCLUSIONS
  Long-term results cast doubt on whether Burch colposuspension should be done during pelvic organ prolapse repair in continent women.
authors.affiliation: Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology, University of Perugia, Perugia, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Costantini
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzeri
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.forename: Michele
authors.initials: M
authors.lastname: Del Zingaro
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zucchi
authors.forename: Massimo
authors.initials: M
authors.lastname: Porena
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D053825:Suburethral Slings; D013997:Time Factors; D014549:Urinary Incontinence / Q000517:prevention & control*; D013520:Urologic Surgical Procedures / Q000379:methods