A 5-year follow-up study comparing Burch colposuspension and transobturator tape for the surgical treatment of stress urinary incontinence

Objective: To compare the effectiveness of transobturator tape (TOT) and Burch colposuspension in the treatment of stress urinary incontinence (SUI). Methods: The present retrospective study included 770 patients who underwent SUI surgery with Burch colposuspension (n = 498) or TOT (n = 272). Clinical follow-up occurred at 2 weeks, 3, 6, and 12 months, and annually thereafter. Objective and subjective cure rates and intra- and postoperative complications were assessed. Results: Among patients who had SUI surgery without another concomitant procedure, the Burch group had a significantly longer mean operation time (41.48 +/- 10.61 minutes versus 23.77 +/- 10.49 minutes; P < 0.001) and a significantly longer length of hospital stay (3.11 +/- 0.49 days versus 1.98 +/- 0.40 days; P < 0.001), compared with the TOT group. The rates of unintended functional outcomes were lower among women undergoing TOT than among those undergoing the Burch procedure (long-term voiding dysfunction 0.7% versus 4.2%, P = 0.007; urinary retention 10.7% versus 26.9%, P < 0.001). The 5-year cure rates were similar in the 2 groups (objective cure rate, 73.9% versus 77.5%, P = 0.574; subjective cure rate, 76.8% versus 81.7%, P = 0.416). Conclusion: In terms of efficacy, TOT appears equal to Burch colposuspension; however, TOT has fewer unintended functional outcomes than Burch colposuspension. Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.