The Ball-Burch procedure for stress incontinence with low urethral pressure.

Up to a 50% failure rate may be expected when genuine stress incontinence with low urethral pressure is treated with routine urethropexy. A combination of Ball and Burch procedures has been suggested as an acceptable alternative to a sling procedure for the condition. In this study, 18 women undergoing a Burch procedure and 48 undergoing a Ball-Burch procedure were available for follow-up urodynamic evaluation. The one-year objective failure rate of the Burch procedure was 38%, and that of the Ball-Burch procedure was 10%, for a statistically significant difference (P less than .05). The Ball-Burch procedure appears to be an effective means of curing women of genuine stress incontinence with low urethral pressure.