Female Urinary Incontinence Surgeries Go Head-to-Head

Trial finds 'sling' procedure gives better results, but has higher complication rate

By Steven Reinberg
HealthDay Reporter

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MONDAY, May 21 (HealthDay News) -- The results of a new head-to-head trial could help women with stress urinary incontinence decide between two surgeries -- called the Burch and the sling -- that are commonly used to correct the condition.

According to the study, "The sling was more effective in resolving urinary incontinence symptoms than the Burch, and it also showed significantly higher satisfaction rates," said study co-author Dr. Michael E. Albo, an associate professor of surgery at the University of California, San Diego. "The trade-off was that there were higher rates of complications with the sling."

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The findings were presented Monday at the American Urological Association's annual meeting in Anaheim, Calif. They will also be published in the May 24 issue of The New England Journal of Medicine.

Doctors already have good evidence as to the benefits and risks of both of these procedures, Albo said, since more than 100,000 operations for urinary incontinence are performed in the United States each year. Based on that history, "we can now counsel our patients about what to expect from these procedures," he said.

The Burch and sling procedures are aimed at correcting "stress urinary incontinence" -- leakage that can result from coughing, laughing, sneezing, running or lifting heavy objects. Both of the surgeries are designed to provide support to the bladder neck and urethra during increases in abdominal pressure that happen with these kinds of activities.

In the sling procedure, a sling made from the patient's own tissue is placed around the urethra for additional support. With the Burch method, sutures are attached to a pelvic ligament to support the urethra. Both procedures require an abdominal incision and an overnight hospital stay.

In the study, 655 women with stress urinary incontinence received either the sling procedure or the Burch.

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