Comparison of the Effectiveness of Burch Colposuspension Versus Suburethral Sling as a Primary Procedure for the Management of Genuine Stress Urinary Incontinence
Drs. E. Lockrow, N. Carlson, J. McBroom, J. Pohl
Walter Reed Army Medical Center
Washington, D. C.

Objective: Compare the success and complications of suburethral sling versus Burch retropubic urethropexy currently used for the treatment of primary genuine stress urinary incontinence.
Methods: A retrospective chart review of 150 patients undergoing either Burch retropubic urethropexy or suburethral sling for the treatment of primary genuine stress incontinence between 1995 and 1999 was conducted. 33 patients in the burch group and 27 patients in the sling group met the selection criteria. Further information was gathered from patients through the use of a survey questionaires. Success of each procedure was defined by a subjective response of no urine leak.
Results: The mean age of the patients in the Burch group 49.6 and in the sling group was 55.1( p=0.105). Height and weight were comparable in both groups. The mean estimated blood loss in the Burch group was 460cc  and in the sling group was 299cc (p=0.011) . There were no postoperative UTI’s in either the Burch or sling group. Immediate postoperative urinary retention was  45.5% in the Burch group and 40.7% in the sling group (p=0.497). There were 2 postoperative blood transfusions in the Burch group and 0 in the sling group.The subjective success rate of the burch group vs the sling group were comparable (62.5% vs 53.8% p=0.638).
Conclusion: this study demonstrates no significant difference in success rates of the Burch vs. the sling procedure.Complication rates between the Burch retropubic urethropexy and the suburethral sling procedure in our institution were also comparable. There was a significant difference in estimated blood loss and transfusion rate which was most likely related to  the significant  difference in concurrent hysterectomy performed in the Burch group as compared to the sling group. In our institution the Burch urethropexy is as good, if not better than the sling procedure for the treatment of primary stress incontinence.