Urinary Incontinence: Rating Surgeries
Sling Procedure May Trump Burch Colposuspension, but May Increase Side Effects
WebMD News Archive
May 22, 2007 -- Researchers have new information on what type of
bladder-control surgery may work best for women with urinary stress
Urinary incontinence, losing urine by accident, can happen for various
reasons. Stress incontinence is caused by physical activities such as exercise,
laughing, sneezing, or coughing.
Treatments for stress incontinence include Kegel exercises to strengthen the
muscles on the pelvic floor, biofeedback, medications, and surgery.
A new study compares two bladder-control surgeries that help support the
urethra, which is connected to the bladder. The two operations are:
- Sling surgery, which uses the patient's tissue to make a sling around the
- Burch colposuspension, in which doctors attach sutures to a pelvic ligament
to support the urethra
The study included 655 women scheduled for urinary stress incontinence. The
researchers included Michael Albo, MD, of the University of California, San
Albo's team randomly assigned half of the women to get sling surgery and the
other half of the group to get Burch colposuspension.
For two years after the operations, the women periodically got checkups and
reported their symptoms and satisfaction with their surgical results.
Incontinence Surgery Results, Side Effects
Two years after surgery, sling surgery had a higher success rate for overall
urinary incontinence, with 47% of sling surgery patients reporting overall
success, compared with 38% of those who got Burch colposuspension.
The success rates specific to stress incontinence were even higher for sling
surgery, with 66% of sling surgery patients reporting success with stress
incontinence, compared with 49% of those who had gotten Burch
However, sling surgery's success came with a higher rate of side effects,
the researchers note.
After sling surgery, women were more likely to develop urinary tract
infections, to have problems emptying their bladders, and to have postsurgery
urge incontinence (overactive bladder), compared to women who got Burch
Success rates for both surgeries "declined steadily during the two-year
follow-up period," the researchers write.
What Is Success?
Patients and doctors often define success differently, with patients having
higher standards for what's acceptable after urinary incontinence surgery
than doctors, note the researchers.