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Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence.

Publication ,  Journal Article
Brubaker, L; Cundiff, GW; Fine, P; Nygaard, I; Richter, HE; Visco, AG; Zyczynski, H; Brown, MB; Weber, AM; Pelvic Floor Disorders Network,
Published in: N Engl J Med
April 13, 2006

BACKGROUND: We designed this trial to assess whether the addition of standardized Burch colposuspension to abdominal sacrocolpopexy for the treatment of pelvic-organ prolapse decreases postoperative stress urinary incontinence in women without preoperative symptoms of stress incontinence. METHODS: Women who did not report symptoms of stress incontinence and who chose to undergo sacrocolpopexy to treat prolapse were randomly assigned to concomitant Burch colposuspension or to no Burch colposuspension (control) and were evaluated in a blinded fashion three months after the surgery. The primary outcomes included measures of stress incontinence (symptoms, stress testing, or treatment) and measures of urge symptoms. Enrollment was stopped after the first interim analysis because of a significantly lower frequency of stress incontinence in the group that underwent the Burch colposuspension. RESULTS: Of 322 women who underwent randomization, 157 were assigned to Burch colposuspension and 165 to the control group. Three months after surgery, 33.6 percent of the women in the Burch group and 57.4 percent of the controls met one or more of the criteria for stress incontinence (P<0.001) [Corrected]. There was no significant difference between the Burch group and the control group in the frequency of urge incontinence (32.7 percent vs. 38.4 percent, P=0.48). After surgery, women in the control group were more likely to report bothersome symptoms of stress incontinence than those in the Burch group who had stress incontinence (24.5 percent vs. 6.1 percent, P<0.001). CONCLUSIONS: In women without stress incontinence who are undergoing abdominal sacrocolpopexy for prolapse, Burch colposuspension significantly reduced postoperative symptoms of stress incontinence without increasing other lower urinary tract symptoms.

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Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

April 13, 2006

Volume

354

Issue

15

Start / End Page

1557 / 1566

Location

United States

Related Subject Headings

  • Vagina
  • Uterine Prolapse
  • Urogenital Surgical Procedures
  • Urodynamics
  • Urinary Incontinence, Stress
  • Urinary Bladder Diseases
  • Urinary Bladder
  • Treatment Outcome
  • Postoperative Complications
  • Middle Aged
 

Citation

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Brubaker, L., Cundiff, G. W., Fine, P., Nygaard, I., Richter, H. E., Visco, A. G., … Pelvic Floor Disorders Network, . (2006). Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med, 354(15), 1557–1566. https://doi.org/10.1056/NEJMoa054208
Brubaker, Linda, Geoffrey W. Cundiff, Paul Fine, Ingrid Nygaard, Holly E. Richter, Anthony G. Visco, Halina Zyczynski, Morton B. Brown, Anne M. Weber, and Anne M. Pelvic Floor Disorders Network. “Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence.N Engl J Med 354, no. 15 (April 13, 2006): 1557–66. https://doi.org/10.1056/NEJMoa054208.
Brubaker L, Cundiff GW, Fine P, Nygaard I, Richter HE, Visco AG, et al. Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med. 2006 Apr 13;354(15):1557–66.
Brubaker, Linda, et al. “Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence.N Engl J Med, vol. 354, no. 15, Apr. 2006, pp. 1557–66. Pubmed, doi:10.1056/NEJMoa054208.
Brubaker L, Cundiff GW, Fine P, Nygaard I, Richter HE, Visco AG, Zyczynski H, Brown MB, Weber AM, Pelvic Floor Disorders Network. Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med. 2006 Apr 13;354(15):1557–1566.

Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

April 13, 2006

Volume

354

Issue

15

Start / End Page

1557 / 1566

Location

United States

Related Subject Headings

  • Vagina
  • Uterine Prolapse
  • Urogenital Surgical Procedures
  • Urodynamics
  • Urinary Incontinence, Stress
  • Urinary Bladder Diseases
  • Urinary Bladder
  • Treatment Outcome
  • Postoperative Complications
  • Middle Aged