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  • Title: Long-term efficacy of Burch colposuspension: a 14-year follow-up study.
    Author: Kjølhede P.
    Journal: Acta Obstet Gynecol Scand; 2005 Aug; 84(8):767-72. PubMed ID: 16026403.
    Abstract:
    BACKGROUND: The aim of this study is to investigate the long-term efficacy of the Burch colposuspension and to analyze the risk factors for an unsuccessful outcome at the long-term follow-up of more than 10 years. METHODS: Data from patient files of 190 women on whom surgery was performed with Burch colposuspension during 1980-1988 and answers from a postal questionnaire performed median 14 years after the Burch colposuspension concerning the lower urinary tract function were retrieved retrospectively. RESULTS: Subjectively significant urinary incontinence was experienced by 56% of the responders. Only 19% reported no incontinence episodes. Among the significant urinary incontinent women, symptoms of stress incontinence occurred in 26%, urge incontinence in 17%, and mixed incontinence in 42%. In 15%, the symptom of incontinence was atypical and could not be categorized. Feeling of incomplete bladder emptying post-operatively and pre-operative obesity was associated with the long-term outcome of Burch colposuspension (odds ratio (OR) = 2.33; 95% confidence interval (95% CI) = 1.20-4.54 and OR = 2.52; 95% CI = 1.10-5.77, respectively). Age, obesity at the long-term follow-up or having had surgery for fecal incontinence, genital prolapse, or hysterectomy were not significantly associated with the outcome of the Burch colposuspension. CONCLUSIONS: The subjective cure rate decreases with time after Burch colposuspension. Lower urinary tract symptoms are very common at the long-term after Burch colposuspension with more than three-fourth experiencing these. Feeling of incomplete bladder emptying post-operatively and pre-operative obesity seem to be long-term risk factors for an adverse outcome. A standard definition for follow-up periods is suggested.
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