Long-Term Results of Burch and Autologous Sling Procedures for Stress Urinary Incontinence in E-SISTEr Participants at 1 Site
Abstract
Purpose:
We report long-term outcomes in participants in the E-SISTEr (Extended Stress Incontinence Surgical Treatment Efficacy Trial) at 1 tertiary care center who underwent a Burch or a fascial sling procedure for stress urinary incontinence.
Materials and Methods:
After receiving institutional review board approval E-SISTEr participants at 1 center who underwent midterm office evaluation in 2010 were further reevaluated at longer term followup by office visits and structured telephone interviews. The telephone interviews were performed by a third party not involved in patient care for those not seen in the last 2 years. Each group received validated questionnaires, including the UDI-6 (Urogenital Distress Inventory-Short Form), the IIQ-7 (Incontinence Impact Questionnaire-Short Form) and the visual analogue quality of life score questionnaire. Failure was measured by Kaplan-Meier curves using time to reoperation for stress urinary incontinence.
Results:
Of the 29 eligible patients, including 14 treated with a Burch procedure and 15 treated with a sling procedure, 21 had long-term information available, including 11 and 10, respectively. Median followup was 15.1 years (range 11.2 to 16.0). One of the 8 patients was lost to followup, 1 died and 7 were unreachable by telephone. The UDI-6 question 3 score was lower for the 13 patients followed by telephone, including 13 and 7 with a Burch and a sling procedure compared to the 8 seen in clinic, including 5 and 3 with a Burch and a sling procedure, respectively (mean ± SD score 0.3 ± 0.6 vs 1.3 ± 1.1, p=0.0208). The UDI-6 scores were similar for the 2 procedures. Stress urinary incontinence reoperation was performed in 3 cases, including placement of a fascial sling in 1 Burch case. The other 2 cases in the Burch and sling groups received an injectable agent at 11.6 and 13.5 years, respectively. The overall Kaplan-Meier 15-year reoperation-free survival rate was 85.2% (95% CI 60.8–95).
Conclusions:
In this well characterized cohort with a median followup of 15.1 years there was sustained improvement in continence scores and quality of life related to stress urinary incontinence in each group and the reoperation rate was low.
References
- 1. : Long-term outcomes after stress incontinence surgery. Obstet Gynecol 2012; 120: 83. Google Scholar
- 2. : Seventeen years' follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J 2013; 24: 1265. Google Scholar
- 3. : Tension-free vaginal tape for treatment of pure urodynamic stress urinary incontinence: efficacy and adverse effects at 17-year follow-up. BJU Int 2013; 122: 113. Google Scholar
- 4. : Long-term patient satisfaction after retropubic and transobturator mid-urethral slings for female stress urinary incontinence. J Obstet Gynaecol Res 2016; 42: 1180. Google Scholar
- 5. : Long-term efficacy of Burch colposuspension: a 14-year follow-up study. Acta Obstet Gynecol Scand 2005; 84: 767. Google Scholar
- 6. : Long-term results of the Stamey bladder neck suspension: direct comparison with the Marshall-Marchetti-Krantz procedure. J Urol 1998; 160: 372. Link, Google Scholar
- 7. : Long-term follow-up of a multicentre randomised controlled trial comparing tension-free vaginal tape, xenograft and autologous fascial slings for the treatment of stress urinary incontinence in women. BJU Int 2015; 115: 968. Google Scholar
- 8. and Urinary Incontinence Treatment Network: Design of the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr). Urology 2005; 66: 1213. Google Scholar
- 9. : Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 2007; 356: 2143. Google Scholar
- 10. : Quality of life after surgery for stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 1631. Google Scholar
- 11. : 5-year continence rates, satisfaction and adverse events of Burch urethropexy and fascial sling surgery for urinary incontinence. J Urol 2012; 187: 1324. Link, Google Scholar
- 12. : Final office evaluation findings in E-SISTEr participants at one center: a glimpse into the long-term results of stress incontinence surgery (abstract 1184). J Urol, suppl., 2012; 187: e480. Link, Google Scholar
- 13. : Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence Impact questionnaire and the urogenital distress inventory. Neurourol Urodyn 1995; 14: 131. Google Scholar
- 14. . Level I/II evidence-based studies of surgical treatment of female stress urinary incontinence: patients lost to followup. J Urol 2011; 185: 1338. Link, Google Scholar
- 15. : Factors influencing the rate of lost to followup after suburethral synthetic sling removal. Urol Pract 2018; 5: 101. Link, Google Scholar
- 16. : Predictability of urodynamic findings based on the Urogenital Distress Inventory-6 questionnaire. Urology 1999; 54: 461. Google Scholar
- 17. : Lessons from a patient experience survey in a randomized surgical trial of treatment of stress urinary incontinence in women. Int Urogynecol J 2011; 22: 1273. Google Scholar
- 18. : Comparison of responsiveness of validated outcome measures after surgery for stress urinary incontinence. J Urol 2010; 184: 2013. Link, Google Scholar
- 19. : Management of recurrent stress urinary incontinence after Burch and sling procedures. Neurourol Urodyn 2016; 35: 344. Google Scholar
The corresponding author certifies that, when applicable, a statement(s) has been included in the study documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number.
No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article.
