Randomised trial of laparoscopic Burch colposuspension versus tension-free vaginal tape: long-term follow up
Article first published online: 7 DEC 2007
RCOG 2008 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Special Issue: Health of women and babies: long-term and intergenerational perspectives
Volume 115, Issue 2, pages 219–225, January 2008
How to Cite
Jelovsek, J., Barber, M., Karram, M., Walters, M. and Paraiso, M. (2008), Randomised trial of laparoscopic Burch colposuspension versus tension-free vaginal tape: long-term follow up. BJOG: An International Journal of Obstetrics & Gynaecology, 115: 219–225. doi: 10.1111/j.1471-0528.2007.01592.x
- Issue published online: 7 DEC 2007
- Article first published online: 7 DEC 2007
- Accepted 15 September 2007.
- Burch cystourethropexy;
- stress incontinence;
- tension-free vaginal tape;
Objective To compare the long-term efficacy of laparoscopic Burch colposuspension with tension-free vaginal tape (TVT) for the treatment of urodynamic stress urinary incontinence (SUI).
Design Long-term follow up from a prospective randomised trial.
Setting Academic tertiary referral centre.
Sample Seventy-two women with urodynamic SUI from two institutions.
Methods Subjects were randomised to either laparoscopic Burch or TVT from August 1999 to August 2002. Follow-up evaluations occurred 6 months, 1 year, 2 years, and 4–8 years after surgery.
Main outcome measures Subjects completed the Incontinence Severity Index, Urogenital Distress Inventory 6 (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Patient Global Impression of Improvement (PGI-I) scales.
Results Median follow-up duration was 65 months (range 12–88 months) with 92% completing at least one follow-up visit. Seventy-four percent of subjects had long-term (4–8 years) follow up. Fifty-eight percent of subjects receiving laparoscopic Burch compared with 48% of TVT subjects reported any urinary incontinence 4–8 years after surgery (Relative Risk (RR):1.19; 95% CI: 0.71–2.0) with no significant difference between groups. Bothersome SUI symptoms were seen in 11 and 8%, respectively, 4–8 years after surgery (P= 0.26). There was significant improvement in the postoperative UDI-6 and IIQ-7 scores in both groups at 1–2 years that were maintained throughout follow up with no significant differences between the groups.
Conclusions TVT has similar long-term efficacy to laparoscopic Burch for the treatment of SUI. A substantial proportion of subjects have some degree of urinary incontinence 4–8 years after surgery; however, the majority of incontinence is not bothersome.