BURCH COLPOSUSPENSION VERSUS TRANSOBTURATOR VAGINAL TAPEPROCEDURE FOR THE TREATMENT OF STRESS URINARY INCONTINENCE IN WOMEN

Abstract

Background: Surgery is offered as the primary treatment option for moderate to severe stress urinary incontinence (SUI) when conservative therapy fails. Burch colposuspension (BCS) is considered the gold standard anti-incontinence surgery and various other options have been described for the treatment of SUI but debate persists regarding the ideal surgical procedure.

Objectives: To compare the effectiveness of Burch colposuspension and transobturator vaginal tape procedure (TVT-O) in the treatment of stress urinary incontinence (SUI).

Materials and methods: This prospective randomised study included 33 patients who underwent SUI corrective surgery either Burch colposuspension (n = 15) or TVT-O (n = 18). The objective and subjective cure rates, surgical trauma, complications and quality of life scores were assessed at one week, one month and six months.

Results: The patients who underwent Burch colposuspension had a significantly longer mean operation time (41.87 ñ 14.47 minutes versus 20.50 ñ 5.22 minutes; P <0.01) and a significantly longer length of hospital stay (4.93 ñ 1.03 days versus 1.83 ñ 0.51 days; P <0.01), compared to patients who had TVT-O insertion. The success rates were similar in both the groups (100% versus 88.9%, P = 0.183). There was no significant difference in two groups in terms of surgical trauma evaluated by serum Interleukin 6 (IL-6) levels (45.92ñ27.89 versus 36.09ñ29.20 p value=0.71) and C-reactive protein (CRP) levels (21.91ñ29.89 versus 13.39ñ41.21 p value=0.06). There was no significant difference in quality of life scores assessed by Kings Health Questionnaire (KHQ) between the two groups.

Conclusion: In terms of efficacy, TVT-O appears equal to Burch colposuspension; however, TVT-O has significantly lesser operating time, post-operative catheterization, post-operative analgesic requirement and post-operative hospital stay.