The burch colposuspension for urinary incontinence in patients with stable and unstable detrusor function

✍ Scribed by Lisbeth Jørgensen; Gunnar Lose; Svend O. Mortensen; Lars Mølsted Pedersen; Jørgen Kviss Kristensen

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 446 KB
• Volume: 7
• Category: Article
• ISSN: 0733-2467
• DOI: 10.1002/nau.1930070504

✦ Synopsis

Eighty patients with urinary incontinence, 61 with stable and 19 with unstable detrusor function, were evaluated preoperatively and postoperatively after Burch colposuspension.

The cure rate in the stable group was found to be 75 % vs. 26% in the unstable group. This difference was highly significant (P < 0.0005). In the unstable group, the major cause of failure was persistent instability. The great controversy in the literature as to the prognostic significance of preoperatively demonstrated detrusor instability when treating urinary incontinence by conventional antiincontinence surgery is suggested to be due to: 1) differences in the cystometric techniques, hence the populations classified with detrusor instability; and 2) difficulties in identification of instability secondary to bladder neck incompetence. The cystometric technique described in this study is considered sufficiently physiologic to allow a reliable identification of true instability, thereby selecting patients who will not benefit from surgery. It is emphasized that there is a need for a thorough standardization of the cystometric technique for classifying true instability and as a basis for comparative studies.