Bladder symptoms 1 year after abdominal sacrocolpopexy with and without Burch colposuspension in women without preoperative stress incontinence symptoms

• Published in: American journal of obstetrics and gynecology 2007-12, Vol.197 (6), p.647.e1-647.e6
• Main Authors: Burgio, Kathryn L., PhD, Nygaard, Ingrid E., MD, Richter, Holly E., PhD, MD, Brubaker, Linda, MD, MS, Gutman, Robert E., MD, Leng, Wendy, MD, Wei, John, MD, Weber, Anne M., MD
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Female; Gynecology. Andrology. Obstetrics; Humans; irritative urinary symptoms; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Obstetrics and Gynecology; obstructive urinary symptoms; pelvic organ prolapse; Prospective Studies; sacrocolpopexy; Time Factors; Urinary Bladder Diseases - etiology; urinary incontinence; Urinary Incontinence - etiology; Urinary Incontinence - prevention & control; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urination Disorders - etiology; Urination Disorders - prevention & control; Urogenital Surgical Procedures - adverse effects; Uterine Prolapse - surgery
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2007.08.048

Objective The objective of the study was to examine changes in bladder symptoms 1 year after abdominal sacrocolpopexy (ASC) with vs without Burch colposuspension. Study Design 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). Conclusion ASC reduced bothersome irritative and obstructive symptoms. Prophylactic Burch reduced stress and urge incontinence.