ICS 1999, Denver
Informally discussed posters
Urodynamics
Obstruction after Burch retropubic urethropexy: the goal of surgery?

Klutke, J; Klutke, C; Bergman, J; Elis, G
University of Southern California Medical Center, Los Angeles, California, USA

Aims of Study: To compare urethral resistance, determined in pressure-flow studies, before and after Burch retropubic urethropexy.

Methods: Urethral resistance was retrospectively determined from pressure-flow studies in 178 patients before and 1 year after Burch retropubic urethropexy. Results of cotton swab tests, pressure transmission to the proximal urethra, and utrethral functional length were also recorded. Results were analyzed statistically using the two-tailed paired t-test.

Results: Urethral resistance increased significantly over preoperative values after successful surgery. The mean urethral resistance in patients in whom surgery failed to cure stress incontinence was unchanged from the preoperative value. There was no direct correlation between stabilizing the bladder bass, as evaluated by the cotton swab test, and cure of stress incontinence.

Conclusions: When successful in curing genuine stress urinary incontinence, the Burch retropubic urethropexy increases urethral resistance. Creating bladder neck support without affecting urethral resistance does not, by itself, restore continence.