Trial: Burch with sacrocolpopexy lowers SUI risk: absolute reduction in risk pegged at 20%.(News)

ATLANTA -- Stress urinary incontinence is common after abdominal sacrocolpopexy for advanced pelvic organ prolapse, but concomitant Burch colposuspension significantly reduces the risk of this outcome, according to findings from the Colpopexy and Urinary Reduction Efforts (CARE) clinical trial.

Stress continent women undergoing sacrocolpopexy for advanced pelvic organ prolapse were randomized to receive a concomitant standardized Burch colposuspension procedure or no Burch procedure.

At 3-month follow-up, about 20% of 157 women in the Burch group, compared with 40% of 165 women in the control group, experienced stress urinary incontinence, Linda Brubaker, M.D., reported at the annual meeting of the American Urogynecologic Society.

Bothersome stress urinary incontinence was particularly improved, with only 6% of those in the Burch group, compared with 24% in the control group, reporting either "moderate" or "quite a bit" of bother in regard to their symptoms, said Dr. Brubaker of Loyola University Chicago, Maywood.

Outcomes did not differ based on findings of preoperative urodynamic testing in this multicenter study, which was conducted by the National Institute of Child Health and Human Development-funded Pelvic Floor Disorders Network.

Patients in the Burch and control groups were similar in age, body mass index, rates of prior urinary incontinence surgery, and other factors such as number of vaginal deliveries. All patients underwent standardized multichannel urodynamic assessment, including prolapse reduction, and the surgical team was blinded to the results of this assessment.

Randomization was disclosed in the ...