OUTCOME OF THE BURCH COLPOSUSPENSION IN OBESE WOMEN

S.A. Malik, B. Özel, J.J. Klutke

USC-Keck School of Medicine, Los Angeles, CA

OBJECTIVE:  Our objective was to evaluate the effect of obesity on the outcome of the Burch colposuspension.

MATERIALS AND METHODS: We prospectively evaluated all women who had the Burch colposuspension procedure between January 2002 and December 2003.  The women were divided into two groups based on body mass index (BMI):  non-obese (BMI < 30 kg/m²), obese (BMI > 30 kg/m²).  Subjective cure was determined by a negative answer to the question “Do you experience urine leakage related to physical activity, coughing, or sneezing?”  Data were analyzed using Fisher’s exact test and Student's t test.

RESULTS:  Eight-three women underwent the Burch colposuspension procedure between January 2002 and December 2003.  Forty-eight women were non-obese, and thirty-five women were obese.  There were no significant differences in age, parity, height, incidence of prior incontinence surgery, pre-operative evidence of detrusor overactivity, or pre-operative MUCP (two sided Student’s t test and Fisher’s exact test, p>0.05).  Concomitant procedures included vaginal or abdominal hysterectomy and abdominal sacral colpopexy with no significant difference between the two groups.  Complications included urinary retention in two subjects in each group (Fisher’s exact test, p=0.99), one enterotomy in each group (Fisher’s exact test, p= 0.99), and one case of de novo urge incontinence in the non-obese group and two in the obese group (Fisher’s exact test, p=0.57).  There was one cystotomy, two wound seromas, two cases of recurrent vault prolapse, one case of hemorrhage requiring repeat laparotomy in the non-obese group and one case of postoperative ileus and one ureteral injury in the obese group.  There was no difference in overall incidence of complications between the two groups (Fisher’s exact test, p=0.99).  Surgical procedures were significantly longer in the obese women [172.3 (39.6) min vs. 204.9 (65.5) min; two-sided Student’s t test, p=0.04].  Subjective cure at a median of 25 weeks (Range 2-119 weeks) was 74.3% and 79.2% in the non-obese and obese women, respectively (Fisher’s exact test, p=0.76).

CONCLUSIONS:  Obesity does not appear to adversely affect the outcome or incidence of complications of the Burch colposupension at short-term follow-up.

Key Words: obesity; Burch colposuspension; stress incontinence  

Disclosure – Consultant: J.J. Klutke, Mentor Corp.