Lebret T, Yonneau L, Chartier-Kastler E, Conort P, Barrou B, Haertig A, Bitker M O, Richard F, Chatelain C
Service d'Urologie, Hôpital de la Pitié, Paris, France.
Prog Urol. 1997 Jun;7(3):426-32.
Burch indirect colposuspension remains the reference surgical operation in the treatment of female urinary stress incontinence. The stability of the results is highly controversial and the causes of failure remain hypothetical. The objective of this study was to analyse the long-term results of this technique.
100 women suffering from pure urinary stress incontinence, in whom a Burch indirect colposuspension was performed, were included in this study. These patients were reviewed with a mean follow-up of 5.2 years and a questionnaire designed to assess the results was sent to their homes.
64% of patients no longer suffered from incontinence. Deterioration of the results was observed up to 5 years after the operation, but subsequently remained stable. The results were operator-independent. Low sphincter pressure (< 30 cm H2O), preoperative detrusor instability, insufficient hormonal impregnation and a history of pelvic surgery were the main factors predictive of failure of this technique.
This study confirms the benefit provided by this technique in almost two-thirds of patients and indicates the risk factors of failure which must be taken into account before proposing Burch indirect colposuspension to a woman suffering from urinary stress incontinence.
Burch间接阴道旁悬吊术仍是治疗女性压力性尿失禁的参考外科手术。其结果的稳定性存在高度争议,失败原因仍属假设。本研究的目的是分析该技术的长期结果。
本研究纳入了100例患有单纯压力性尿失禁且接受了Burch间接阴道旁悬吊术的女性。对这些患者进行了平均5.2年的随访,并向她们家中发送了一份旨在评估结果的问卷。
64%的患者不再患有尿失禁。术后5年内观察到结果恶化,但随后保持稳定。结果与术者无关。低括约肌压力(<30 cm H2O)、术前逼尿肌不稳定、激素浸润不足和盆腔手术史是该技术失败的主要预测因素。
本研究证实了该技术在近三分之二患者中的益处,并指出了在向患有压力性尿失禁的女性推荐Burch间接阴道旁悬吊术之前必须考虑的失败风险因素。