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Long-term clinical outcomes with the retropubic tension-free vaginal tape (TVT) procedure compared to Burch colposuspension for correcting stress urinary incontinence (SUI)

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Abstract

Introduction and hypothesis

The retropubic tension-free vaginal tape (TVT) procedure replaced Burch colposuspension as the primary surgical method for stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) in women in our department in 1998. In this study we compared the short-term and long-term clinical outcomes of these surgical procedures.

Methods

Using a case series design, we compared the last 5 years of the Burch procedure (n = 127, 1994–1999) with the first 5 years of the retropubic TVT procedure (n = 180, 1998–2002). Information from the medical records was transferred to a case report form comprising data on perioperative and long-term complications as well as recurrence of UI, defined as bothersome UI or UI in need of repeat surgery. Other endpoints were rates of perioperative and late complications and the rates of prolapse surgery after primary surgery. The data were analyzed with the chi-squared and t tests and survival analysis using SPSS.

Results

The cumulative recurrence rate of SUI in women with preoperative SUI was significantly higher after the Burch procedure, but no difference was observed in women with MUI. There were no significant differences in rates of perioperative and late complications. At 12 years there was a significant increase in rates of repeat surgery for incontinence and prolapse in women after the Burch procedure.

Conclusions

The long-term efficacy of TVT surgery was superior to that of Burch colposuspension in women with SUI. In addition, the rate of late prolapse surgery was significantly higher after the Burch procedure.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nordland Hospital, Parkveien 95, 8005, Bodø, Norway

    Bjørn Holdø

  2. Division of Surgery, Oncology and Women’s Health, University Hospital of North Norway, Tromsø, Norway

    Margareta Verelst

  3. Department of Obstetrics and Gynecology, Oslo University Hospital, Ullevål, Oslo, Norway

    Rune Svenningsen

  4. Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

    Ian Milsom

  5. Institute of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway

    Finn Egil Skjeldestad

Authors
  1. Bjørn Holdø
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  2. Margareta Verelst
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  3. Rune Svenningsen
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  4. Ian Milsom
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  5. Finn Egil Skjeldestad
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Corresponding author

Correspondence to Bjørn Holdø.

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Funding

The study received funding from Nordland Hospital, Bodø, Norway.

Conflicts of interest

B. Holdø: none.

M. Verelst: none.

R. Svenningsen: Advisory board Astellas and speaker fees from Astellas.

I. Milsom: none.

F.E. Skjeldestad: none.

Additional information

Key message

TVT is superior to Burch colposuspension for treatment of SUI.

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Holdø, B., Verelst, M., Svenningsen, R. et al. Long-term clinical outcomes with the retropubic tension-free vaginal tape (TVT) procedure compared to Burch colposuspension for correcting stress urinary incontinence (SUI). Int Urogynecol J 28, 1739–1746 (2017). https://doi.org/10.1007/s00192-017-3345-0

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  • DOI: https://doi.org/10.1007/s00192-017-3345-0

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