BURCH COLPOSUSPENSION - A 10-20 YEAR FOLLOW-UP

Objective To review the outcome of women who underwent Burch colposuspension 10 to 20 years ago and to assess factors which affect long term success. Design Longitudinal retrospective study. Setting Urogynaecology Unit, St George's Hospital, London. Subjects One hundred and nine women with genuine stress incontinence. Main outcome measures Survival analysis of subjective and objective cure of stress incontinence. Results Cure of incontinence following Burch colposuspension is time-dependent, with a decline for 10 to 12 years when a plateau of 69% is reached. Factors adversely affecting cure are previous bladder neck surgery (logrank test P = 0.02), pre-operative weight greater than 80 kg, intra-operative blood loss more than 1000 ml and the development of post-operative detrusor instability. Post-operative complications included de novo detrusor instability (14.7%), long term complaints of voiding difficulty with objective recovery at the final follow up (22%) and recurrent urinary tract infection (4.6%). Conclusions Long term follow up after colposuspension is necessary to assess sequelae. We suggest that new continence procedures should be followed up for 5 to 10 years.