Prognostic factors and long-term results of the Burch colposuspension. A retrospective study.

The purpose of this retrospective study was to evaluate the importance of different preoperative estimates and postoperative complications on the outcome of the Burch colposuspension with respect to urinary continence. During the period 1980-1988 243 women were operated upon with the Burch colposuspension for stress incontinence or mixed incontinence. The patient records have been analysed with respect to preoperative assessments and postoperative complications. 236 patients were alive at the follow-up, median 6 years after operation, and 232 (98%) answered a postal questionnaire about their present urinary symptoms. According to the postal questionnaire the overall cure-rate was 63 per cent, another 27 per cent were improved. Prognostic factors for an unsuccessful outcome of the operation were previous urinary incontinence surgery, postoperative febrile morbidity, and immediate voiding difficulties (stranguria and difficulties emptying the urinary bladder). At the follow-up the voiding difficulties were still significantly more often seen in patients not cured from incontinence than among women cured by the colposuspension. Among the patients with recurrent incontinence we also found a significantly higher rate of lower urinary tract infections ( > 3 UTI per year). The continence rate was found to be almost constant between the second and tenth year postoperatively. No significant differences in preoperatively measured maximal urethral closure pressure and functional urethral length were found between cured and not cured patients. Although not significant, the cure-rate showed a tendency to decrease with age at the operation, both in the short-term result as well as the long-term result.