Patient related factors associated with long-term urinary continence after Burch colposuspension and pubovaginal fascial sling surgeries Journal Article

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Authors: Richter, H. E.; Brubaker, L; Stoddard, A. M.; Xu, Y; Zyczynski, H. M.; Norton, P.; Sirls, L. T.; Kraus, S. R.; Chai, T. C.; Zimmern, P; Gormley, E. A.; Kusek, J. W.; Albo, M. E.; Urinary Incontinence Treatment Network
Article Title: Patient related factors associated with long-term urinary continence after Burch colposuspension and pubovaginal fascial sling surgeries
Abstract: PURPOSE: We examined preoperative and postoperative patient related factors associated with continence status up to 7 years after surgery for stress urinary incontinence. MATERIALS AND METHODS: Women randomized to Burch colposuspension or fascial sling surgery and assessed for the primary outcome of urinary continence 2 years after surgery were eligible to enroll in a prospective observational study. Survival analysis was used to investigate baseline and postoperative factors in the subsequent risk of stress urinary incontinence, defined as self-report of stress urinary incontinence symptoms, incontinence episodes on a 3-day diary or surgical re-treatment. RESULTS: Of the women who participated in the randomized trial 74% (482 of 655) were enrolled in the followup study. Urinary continence rates decreased during a period of 2 to 7 years postoperatively from 42% to 13% in the Burch group and from 52% to 27% in the sling group, respectively. Among the baseline factors included in the first multivariable model age (p = 0.03), prior stress urinary incontinence surgery (p = 0.02), menopausal status (0.005), urge index (0.006), assigned surgery (p = 0.01) and recruiting site (p = 0.02) were independently associated with increased risk of incontinence. In the final multivariable model including baseline and postoperative factors, Burch surgery (p = 0.01), baseline variables of prior urinary incontinence surgery (p = 0.04), menopausal status (p = 0.03) and postoperative urge index (p 0.001) were each significantly associated with a greater risk of recurrent urinary incontinence. CONCLUSIONS: Preoperative and postoperative urgency incontinence symptoms, Burch urethropexy, prior stress urinary incontinence surgery and menopausal status were negatively associated with long-term continence rates. More effective treatment of urgency urinary incontinence in patients who undergo stress urinary incontinence surgery may improve long-term overall continence status.
Journal Title: The Journal of urology
Volume: 188
Issue: 2
ISSN: 1527-3792; 0022-5347
Publisher: Unknown  
Journal Place: United States
Date Published: 2012
Start Page: 485
End Page: 489
Language: eng
DOI/URL:

10.1016/j.juro.2012.04.010

10.1016/j.juro.2012.04.010
Notes: CI: Copyright (c) 2012; ClinicalTrials.gov/NCT00064662; GR: U01 DK060380/DK/NIDDK NIH HHS/United States; GR: U01 DK58225/DK/NIDDK NIH HHS/United States; GR: U01 DK58229/DK/NIDDK NIH HHS/United States; GR: U01 DK58231/DK/NIDDK NIH HHS/United States; GR: U01 DK58234/DK/NIDDK NIH HHS/United States; GR: U01 DK60379/DK/NIDDK NIH HHS/United States; GR: U01 DK60380/DK/NIDDK NIH HHS/United States; GR: U01 DK60393/DK/NIDDK NIH HHS/United States; GR: U01 DK60395/DK/NIDDK NIH HHS/United States; GR: U01 DK60397/DK/NIDDK NIH HHS/United States; GR: U01 DK60401/DK/NIDDK NIH HHS/United States; JID: 0376374; NIHMS395009; OID: NLM: NIHMS395009 [Available on 08/01/13]; OID: NLM: PMC3560926 [Available on 08/01/13]; PMCR: 2013/08/01 00:00; 2011/12/06 [received]; 2012/06/15 [aheadofprint]; ppublish