Urologic Diseases Research Updates
UITN Presents 5-year Report Card on Burch and Fascial Sling Surgeries
NIH-funded Study Finds Most Women Satisfied with Procedures Despite Decreasing Continence
In a follow-up study to the largest and most rigorous U.S. trial comparing two traditional operations for stress urinary incontinence in women, researchers found the Burch urethropexy and fascial sling surgery both resulted in decreased rates of continence 5 years after the operation. Among women who received the Burch procedure, only 24.1 percent remained continent. The fascial sling surgery resulted in a slightly better 30.8 percent continence rate.
In 2007, the Urinary Incontinence Treatment Network (UITN), supported by the National Institutes of Health (NIH), initiated the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr), randomizing 655 women into two groups. One group received the Burch urethropexy, in which sutures are attached to a pelvic ligament to support the urethra; the other received the fascial sling, in which a sling is made from the patient’s own tissue and placed around the urethra for additional support.
Two years after surgery, complete information on measures used to assess urinary incontinence was available for 520 participants (79 percent). Of these remaining women, 38 percent who had a Burch procedure and 47 percent who had the sling procedure were dry overall, including leakage that could have been caused by urge incontinence. Considering only stress-specific leakage, 49 percent of women with a Burch procedure and 66 percent with a sling were dry.
At the 5-year point in the study, 482 (74 percent) participants remained in the trial. Even though continence rates had decreased for both groups, satisfaction remained relatively high at 73 percent for the Burch group and 83 percent for the fascial sling group.
Adverse event rates were similar for the two groups at 10 percent for the Burch group and 9 percent for the fascial sling group.
Linda Brubaker, M.D., Loyola University (Chicago) Medical Center, a member of the UITN, said, “Women who participate in research contribute in an important way when they agree to participate in long-term follow-up studies. These studies allow researchers to understand the consequences of medical and surgical treatments over many years after the initial treatment.”
The NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Office of Research on Women’s Health funded the UITN, a group of nine clinical centers and a biostatistical center, to conduct a series of rigorous, long-term trials of common incontinence therapies.
NIH Publication No. 13–5743
Page last updated January 31, 2013