International Urogynecology Journal

, Volume 15, Issue 3, pp 183–187 | Cite as

Tension-free vaginal tape, Burch, and slings: are there predictors for early postoperative voiding dysfunction?

  • Vatche A. Minassian
  • Ahmed Al-Badr
  • Harold P. Drutz
  • Danny Lovatsis
Original Article


This study compared the incidence, duration, and predictors of early postoperative voiding dysfunction (VD) after three continence operations. Charts of women undergoing tension-free vaginal tape (TVT), Burch, or suburethral sling were reviewed. Early postoperative VD was defined as urinary retention or postvoid residual (PVR) >200 ml at discharge. Analysis of variance, Chi-square, and non-parametric tests were used. Sixty-three TVT, 42 Burch and 33 slings were identified. Incidence of VD with TVT, sling, and Burch was 50, 24, and 15%, respectively (P <0.001), and the mean number of days of postoperative catheter use was 9, 21, and 5 days, respectively (P=0.04). Patients with VD, compared with those with normal voiding, had smaller preoperative PVR (50 vs. 75 ml, P=0.005), longer catheterization (29 vs. 3 days, P<0.001), and more urinary tract infections (43 vs. 15%, P<0.001). Early postoperative VD is an underreported but frequent postoperative complication which is difficult to predict.


Burch Incontinence Sling TVT Voiding dysfunction 


  1. 1.
    Burch JC (1961) Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele, and prolapse. Am J Obstet Gynecol 81:281–290Google Scholar
  2. 2.
    Burch JC (1968) Cooper’s ligament urethrovesical suspension for stress incontinence. Am J Obstet Gynecol 100:764–774PubMedGoogle Scholar
  3. 3.
    Alcalay M, Monga A, Stanton SL (1995) Burch colposuspension: a 10–20 year follow up. Br J Obstet Gynaecol 102:740–745PubMedGoogle Scholar
  4. 4.
    Amaye-Obu FA, Drutz HP (1999) Surgical management of recurrent stress urinary incontinence: a 12-year experience. Am J Obstet Gynecol 181:1296–1309Google Scholar
  5. 5.
    Langer R, Lipshitz Y, Halperin R, Pansky M, Sherman D (2001) Long-term (10–15 years) follow-up after Burch colposuspension for urinary stress incontinence. Int Urogynecol J 12:323–327CrossRefPubMedGoogle Scholar
  6. 6.
    Goebel R (1910) Zur operativen beseitigung der angelborenen. Incontinentia Vesicae Z Gynakol Urol 2:187Google Scholar
  7. 7.
    Kohli N, Karram MM (1999) Surgery for genuine stress urinary incontinence: Vaginal procedures, injections, and the artificial urinary sphincter. In: Walters MD, Karram MM (eds) Urogynecology and reconstructive pelvic surgery. Mosby, St. Louis, pp 171–176Google Scholar
  8. 8.
    Morgan JE, Farrow GA, Stewart FE (1985) The Marlex sling operation for the treatment of recurrent stress urinary incontinence: a 16-year review. Am J Obstet Gynecol 151:224–226Google Scholar
  9. 9.
    Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 7:81–86Google Scholar
  10. 10.
    Nilsson CG, Kuuva N, Falconer C, Rezapour M, Ulmsten U (2001) Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J 12 [Suppl 2]: S5–S8Google Scholar
  11. 11.
    Rezapour M, Ulmsten U (2001) Tension-Free vaginal tape (TVT) in women with recurrent stress urinary incontinence—a long-term follow up. Int Urogynecol J 12 [Suppl 2]: S9–S11CrossRefGoogle Scholar
  12. 12.
    Nygaard IE, Kreder KJ (1994) Complications of incontinence surgery. Int Urogynecol J 5:353–360Google Scholar
  13. 13.
    Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81:72–77Google Scholar
  14. 14.
    Dainer M, Cynthia DH, Choe J, Bhatia NN (1998) The Burch procedure: a comprehensive review. Obstet Gynecol Survey 239–250Google Scholar
  15. 15.
    Klutke C, Siegel S, Carlin B, Paszkiewicz E, Kirkemo A, Klutke J (2001) Urinary retention after tension-free vaginal tape procedure: incidence and treatment. Urology 58:697–701CrossRefPubMedGoogle Scholar
  16. 16.
    Morgan JE (1970) A sling operation, using Marlex polypropylene mesh, for treatment of recurrent stress incontinence. Am J Obstet Gynecol 106:369–377PubMedGoogle Scholar
  17. 17.
    Al-Badr A, Ross S, Soroka D, Minassian VA, Karahalios A, Drutz HP (2003) Voiding patterns and urodynamics after Tension-free Vaginal Tape procedure. J Obstet Gynaecol Can 25:725–730PubMedGoogle Scholar
  18. 18.
    Kleeman S, Goldwasser S, Vassallo B, Karram M (2002) Predicting postoperative voiding efficiency after operation for incontinence and prolapse. Am J Obstet Gynecol 187:49–52CrossRefPubMedGoogle Scholar
  19. 19.
    Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardization of terminology of lower urinary tract function: report from the standardization sub-committee of the International Continence Society. Neurol and Urodyn 21:167–178CrossRefGoogle Scholar
  20. 20.
    Theofrastous JP, Addison WA, Timmons MC (1996) Voiding function following prolapse surgery: impact of estrogen replacement. J Reprod Med 41:881–884PubMedGoogle Scholar
  21. 21.
    Bhatia NN, Bergman A (1986) Use of preoperative uroflowmetry and simultaneous urethrocystometry for predicting risk of prolonged postoperative bladder drainage. Urology 28:440–445PubMedGoogle Scholar
  22. 22.
    FitzGerald MP, Brubaker L (2001) The etiology of urinary retention after surgery for genuine stress incontinence. Neurourol Urodynam 20:13–21CrossRefGoogle Scholar
  23. 23.
    Stanton SL, Cardozo LD (1979) Results of the colposuspension operation for incontinence and prolapse. Br J Obstet Gynecol 86:693–697Google Scholar
  24. 24.
    Kobak WH, Walters MD, Piedmonte MR (2001) Determinants of voiding after three types of incontinence surgery: a multivariable analysis. Obstet Gynecol 97:86–91Google Scholar

Copyright information

© International Urogynecological Association 2004

Authors and Affiliations

  • Vatche A. Minassian
    • 1
  • Ahmed Al-Badr
    • 1
  • Harold P. Drutz
    • 1
  • Danny Lovatsis
    • 1
  1. 1.Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and GynecologyMount Sinai Hospital, University of TorontoTorontoCanada

Personalised recommendations