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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2001 June;160(3):101-3

language: Italian

Burch colposuspension in genuine stress urinary incontinence

Grio R., Cellura A., Colla F., Piacentino R.

Università degli Studi - Torino, Dipartimento di Discipline Ginecologiche ed Ostetriche, Cattedra B e Cattedra C


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Background. In women, genuine stress urinary incontinence is a major urogynaecological pathology that provokes a disastrous impact on the quality of life. The highly negative repercussions of this condition on the patient’s physical, mental, sexual, relational and social activity are in fact well known. The purpose of the present study is to assess the role of Burch’s colposuspension in the treatment of this severe condition.
Methods. In the period between March 1997 and October 1998 in Section C of the Depart-ment of Gynaecology and Obstetrics of the University of Turin, 27 patients aged between 40 and 70 (average 55) suffering from effort-related urinary incontinence underwent Burch’s colposuspension operation. The operating series was selected on the basis of urodynamic tests showing the failed functioning of the closing mechanism (sphincter insufficiency) owing to a transmission defect of intra-abdominal pressure on the urethra, under load conditions, with pelvic floor insufficiency. Excluded from the operation were patients who, although in the presence of transmission defects, presented other factors associated with bladder pathology (detrusor instability, urethral sphincter damage, etc.). The surgical outcome was monitored at 6 months in 11 cases, and at 18 months from the operation in the other 16 cases. The result was evaluated by defining as positive cases in which subjective symptoms disappeared totally. The cases in which it was recorded that symptoms were not modified or simply improved were classified as negative.
Results. Of a total of 27 cases treated, 85% were positive and 15% negative.
Conclusions. The results obtained were comparable to those in the national and international literature and enable us to conclude that Burch’s colposuspension operation is the surgery of choice in all cases of genuine stress urinary incontinence.

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