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

Holly E. Richter, Linda Brubaker, Anne M. Stoddard, Yan Xu, Halina M. Zyczynski, Peggy Norton, Larry T. Sirls, Stephen R. Kraus, Toby C. Chai, Philippe Zimmern, E. Ann Gormley, John W. Kusek, Michael E. Albo

Research output: Contribution to journalArticle

18 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)485-489
Number of pages5
JournalJournal of Urology
Volume188
Issue number2
DOIs
StatePublished - Aug 2012

Keywords

  • operative
  • stress
  • surgical procedures
  • treatment outcome
  • urge
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

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    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. (2012). Patient related factors associated with long-term urinary continence after burch colposuspension and pubovaginal fascial sling surgeries. Journal of Urology, 188(2), 485-489. https://doi.org/10.1016/j.juro.2012.04.010