Introduction: Many surgical procedures have been proposed for treatment of stress urinary
incontinence (SUI) but none of them has proved completely successful. The aim of this study is to compare
the efficacy and safety of tension free vaginal tape (TVT) with Burch colposuspension in the treatment of
SIU. Patients and Methods: Fifty female patients, presenting with SUI were randomly divided into two
equal groups. SUI was confirmed using urodynamic study in all patients. Group 1 (n ¼ 25) patients
underwent Burch colposuspension while Group 2 (n ¼ 25) underwent TVT. Patients with high grade
cystocele, previous surgical failure for SUI, uninhibited detrusor contraction during bladder filling on
urodynamic study and incompetent internal sphincters were excluded from this study. A patient was
declared cured of SUI, if 3–6 months after surgery she had no SUI. The procedure was judged to be a
failure if 3–6 months after surgery, patient had SUI. Results: In group 1 patients, 72% were completely
cured, 16% improved and 12% showed no improvement. In group 2 patients, 72% were completely cured,
20% improved and only 8% showed no improvement. There was no difference between the two groups in
terms of cure rates. Operative time for TVT was significantly less compared to Burch. Postoperative pain
was less in TVT than Burch. Return to normal activity was earlier in TVT compared to Burch group. Intra
operative perforation of the urinary bladder occurred in 8% of patients in group 2. Urine retention
occurred in 12% of patients in group 1 compared to 20% in group 2. This was successfully managed
conservatively. De novo urgency developed in 12% in group I and 8% in group II and was successfully
managed by medical treatment. Conclusion: The success rates of TVT and Burch colposuspension in the
treatment of SUI in our experience are very similar. However, TVT is associated with less morbidity. We
recommend TVT procedure for females with genuine SUI. |
