Burch Colposuspension Procedure in Postmenopausal Women

Hülya DEDE, Akın SİVASLIOĞLU, F. Suat DEDE, Erol AKKÖK, Orhan GELİŞEN, İsmail DÖLEN,
Ankara-Turkey

OBJECTIVE: To evaluate the short-term as well as the long-term results of Burch colposuspension procedure in the treatment of stress or mixed urinary incontinence in postmenopausal women.
STUDY DESIGN: We reviewed the records of 36 postmenopausal women who underwent Burch colposuspension between January 2001 and March 2003 with a mean follow-up of 26 months. One-hundred-eighteen premenopausal patients managed by Burch colposuspension during the same period of time were served as controls. Preoperative investigation consisted of clinical history, pelvic examination, laboratory evaluation and only in cases with recurrent incontinence, urodynamic evaluation. A telephone survey was performed with all patients to evaluate their symptoms and the impact on their quality of life.
RESULTS: Thirty-six postmenopausal patients were enrolled in the study and 6 (16.7%) of them were taking hormone therapy (HT). Burch colposuspension was performed solely in 75% (n=27) of postmenopausal patients and in 48.3% (n=57) of premenopausal women. Four (11.1%) women in postmenopausal group and 4 (3.4%) women in premenopausal group had intra or early postoperative complications (p=0.09). There was no significant difference in the cure rate between premenopausal and postmenopausal women (p=0.25) and no significant difference was observed in the surgical outcome in postmenopausal patients with respect to HT. Significantly higher cure rates were observed in patients with primary incontinence when compared with recurrent incontinence both in premenopause and postmenopause groups (p=0.003).
CONCLUSION: Our results indicate that Burch colposuspension procedure is a safe and effective choice of treatment for stress urinary incontinence as a first step procedure, regardless of menopausal status. Hormone therapy may improve cure rates in postmenopausal women but studies with large number of series are needed to clarify the possible positive effect of HT on surgical outcome in the incontinence surgery in postmenopausal women.
(Gynecol Obstet Reprod Med 2005; 11:120-123)

Key Words: Burch colposuspension, Menopause, Outcome