| Abstract [eng] |
Background /objective The purpose of this work was to present the distant results and complications of a classical Burch‘s colposuspension, to compare it with the method of raising by means of sub-urethral slings, and to determine which method of treatment suits the patient’s needs best. Patients and methods In the period from 1996 to 2005, 325 Burch‘s colposuspensions were performed. The implanting of sub-urethral slings ("Sparc") was started in 2002, however, only three surgeries were performed due to the high cost of the surgical set. This work retrospectively analyses distant results for 103 patients on which open Burch’s surgery was performed. All patients suffered from urinary incontinence during physical load (confirmed by clinical investigation, urodynamic tests and colpocystography). The patients were examined on an outpatient basis and filled in questionnaires on the evaluation of surgery results and quality of life. Distant results after Burch‘s colposuspension were evaluated after five years; results of sub-urethral sling implantation could not be evaluated as too few surgeries had been performed. Therefore, results of Burch‘s open colposuspensions performed by us are compared with the results of sling implantations described in the literature. Indications and contraindications to Burch‘s open surgery and sub-urethral sling implantation are also compared. Results Very good and goods results five years after Burch‘s open surgery were established for 82 patients (79.6%), medium for 16 patients (15.5%) and bad results for five patients (4.9%). According to the literature, 71 to 88% of patients recovered within five years after Burch‘s surgery. This shows the effectiveness of this operation in treating urinary incontinence in women. The following results of sub-urethral sling implantation are presented in the literature: 74 to 90% patients recovered within five years after TVT surgery and 83% patients after "Sparc" surgery. Surgical complications and urination disorders are potential complications during Burch‘s open colposuspension surgery and sub-urethral sling implantation as well as in the postoperative period. According to the literature, more complications are reported after sling implantations than after Burch‘s colposuspension. Sub-urethral sling surgery has expanded the range of indications for the surgical treatment of urinary incontinence in women. These operations are simple and do not take much time, however, they are still expensive in Lithuania. Conclusions A comparison of the results Burch‘s open colposuspension and sub-urethral sling implantation has shown that these surgeries are similar, each having its indications, failures and complications. While identifying indications for surgical treatment, one should bear in mind that the first surgery may be decisive for the patient’s future. Therefore, the choice of the method should be individual in each case and ensure long-term effects, favourable forecast and aesthetic appearance as well as guarantees to the patient. |
