Long-term results of the Burch procedure combined with abdominal sacrocolpopexy for treatment of vault prolapse
| Autor: | Denis Querleu, Malik Boukerrou, B. Occelli, Gilles Crépin, Michel Cosson, Fabrice Narducci |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
medicine.medical_specialty Urinary Incontinence Stress Urology medicine.medical_treatment Urinary incontinence Suture (anatomy) Uterine Prolapse medicine Humans Aged Hysterectomy Abdominal sacrocolpopexy Sacrococcygeal Region business.industry Burch procedure Suture Techniques Obstetrics and Gynecology Mean age Long term results Middle Aged Urogenital Surgical Procedures Surgery Log-rank test Treatment Outcome Female medicine.symptom business Follow-Up Studies |
| Zdroj: | International Urogynecology Journal and Pelvic Floor Dysfunction. 14:104-107 |
| ISSN: | 1433-3023 0937-3462 |
| Popis: | The aim of the study was to determine the long-term results of Burch procedures combined with vault prolapse repair by abdominal sacrocolpopexy. Between 1986 and 1997 82 women (mean age 46.0 years, range 27-79) underwent sacrocolpopexy combined with a Burch procedure. All patients presented with urinary incontinence and vault prolapse. The surgery consisted of a Burch procedure using non-absorbable suture material, and abdominal sacrocolpopexy with a non-absorbable mesh. The mesh was placed anteriorly and posteriorly in 66 cases, posteriorly (rectovaginal) in 12, and anteriorly (vesicovaginal) in 4. Additional procedures included hysterectomy (34 cases), enterocele repair (79 cases), and posterior repair with perineorrhaphy (65 cases). Failure was defined as the presence of persistent or worsened postoperative stress urinary incontinence (SUI). At a mean follow-up of 86 months (range 24-133) 34% (28/82) of patients were dry, and another 46% (38/82) were improved compared to their preoperative status. The postoperative SUI rate (persistent, worsened) after the placement of a single anterior mesh (4 failures out of 4) was higher than the postoperative SUI rate after combined meshes (41 failures out of 66) (log rank P = 0.05). All the patients with a history of prior surgery had worsened or persistent stress urinary incontinence (7/7), but 63% (47/75) of those with no prior surgery for stress urinary incontinence had worsened or persistent stress urinary incontinence (log rank P = 0.01). One case of recurrent rectocele was observed (after 20 months) and treated by transvaginal Richter sacrospinous fixation. At a mean follow up of 7 years, the Burch procedure combined with abdominal sacrocolpopexy appears to be less effective than previously published long-term results for the Burch procedure alone. |
| Databáze: | OpenAIRE |
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