Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology, University of Perugia, Perugia, Italy.
J Urol. 2011 Jun;185(6):2236-40. doi: 10.1016/j.juro.2011.01.078. Epub 2011 Apr 16.
We reevaluated and brought up to date the 8-year followup of a previous published, randomized, controlled trial of the impact of Burch colposuspension as a prophylactic anti-incontinence procedure in patients without urinary incontinence who underwent abdominal pelvic organ prolapse repair.
A total of 66 continent women with pelvic organ prolapse were randomly assigned to abdominal pelvic organ prolapse repair and concomitant Burch colposuspension in 34 (group 1) or pelvic organ prolapse repair alone without an anti-incontinence procedure in 32 (group 2). Primary study end points were the anatomical outcome and changes in incontinence status. Secondary end points were changes in subjective symptoms and quality of life.
Median followup was 97 months (range 72 to 134). Three group 1 and 1 group 2 patients were lost to followup. Three group 1 patients had a stage I rectocele and 1 had a stage I cystocele. Four group 2 patients had a stage I rectocele and 3 had a stage I cystocele. Nine of 31 group 1 patients (29%) were incontinent compared with 5 of 31 (16%) in group 2 (p = 0.553). In group 1 all except 1 patient were successfully treated for voiding dysfunction. Storage symptoms had disappeared in 1 patient and de novo storage symptoms had developed in 2 since the previous followup. De novo incontinence developed in 2 group 2 patients after midterm outcomes were reported. Median Urogenital Distress Inventory-6 and Incontinence Impact on Quality of Life-7 scores were improved in all groups at last followup (p 0.0001).
Long-term results cast doubt on whether Burch colposuspension should be done during pelvic organ prolapse repair in continent women.
我们重新评估并更新了先前发表的一项随机对照试验的 8 年随访结果，该试验评估了在无尿失禁的患者中，行腹盆腔器官脱垂修复术时行 Burch 耻骨后悬吊术作为预防性抗失禁手术的效果。
共有 66 名无尿失禁的盆腔器官脱垂患者被随机分配至行腹盆腔器官脱垂修复术和同期 Burch 耻骨后悬吊术（第 1 组，34 例）或单纯行盆腔器官脱垂修复术而不进行抗失禁手术（第 2 组，32 例）。主要研究终点为解剖学结果和尿失禁状况的变化。次要终点为主观症状和生活质量的变化。
中位随访时间为 97 个月（范围 72 至 134）。第 1 组中有 3 名患者和第 2 组中有 1 名患者失访。第 1 组中有 3 名患者出现 I 度直肠膨出，1 名患者出现 I 度膀胱膨出。第 2 组中有 4 名患者出现 I 度直肠膨出，3 名患者出现 I 度膀胱膨出。第 1 组中有 31 名患者（29%）存在尿失禁，而第 2 组中有 31 名患者（16%）存在尿失禁（p = 0.553）。第 1 组中除 1 名患者外，所有患者的排尿功能障碍均得到成功治疗。1 名患者的储存症状消失，2 名患者出现新的储存症状。2 名第 2 组患者在中期结果报告后出现新的尿失禁。所有患者的尿失禁生活质量问卷 7 项简表评分和女性尿失禁生活质量问卷 6 项简表评分在末次随访时均得到改善（p 0.0001）。
长期结果令人怀疑在无尿失禁的女性中，在行盆腔器官脱垂修复术时是否应行 Burch 耻骨后悬吊术。
