BURCH COLPOSUSPENSION VERSUS MODIFIED MARSHALL-MARCHETTI-KRANTZ URETHROPEXY FOR PRIMARY GENUINE STRESS URINARY-INCONTINENCE - A PROSPECTIVE, RANDOMIZED CLINICAL-TRIAL

OBJECTIVE: Our purpose was to compare the effects of the Burch colposuspension with those of the modified Marshall-Marchetti-Krantz urethropexy. STUDY DESIGN: Eighty women underwent the two types of operation. A full urodynamic investigation was repeated 6 months after surgery. RESULTS: Clinical follow-up continued for 2 to 7 years. Differences in subjective and objective cure rates were not statistically significant (respectively, 92% and 80% for the Burch colposuspension and 85 and 65% for the modified Marshall-Marchetti-Krantz urethropexy). The latter induced a longer hospital stay (7.4 vs 6.3 days, p = 0.001), a later resumption of spontaneous voiding (13.8 vs 8.5 days, p = 0.002), and was associated with considerable complications (one case of blood replacement for retropubic hematoma, one case of severe voiding difficulty, one case of further treatment for stress incontinence, and three cases of symptomatic de novo detrusor instability). CONCLUSION: For its high cure rate, short time to resumption of spontaneous voiding, short hospital stay, and low associated morbidity, the Burch colposuspension should remain the procedure of choice for stress incontinence.