Female Urinary Incontinence Surgeries Go Head-to-Head

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The researchers found that two years after the procedures, 47 percent of the women who had the sling were dry overall compared with 38 percent on the women who had the Burch. For women who suffered stress incontinence, 66 percent who had the sling procedure remained dry compared with 49 percent who had the Burch.

Most women in the study said they were satisfied with the results of their treatment, whichever surgery they had received. However, 86 percent women with the sling surgery were satisfied compared with 78 percent of women who had the Burch.

On the other hand, there were more side effects noted among women who received the sling, the researchers found. The most common were urinary tract infections, which affected 63 percent of women with a sling and 47 percent of women with a Burch. The sling also had more voiding problems associated with it (14 percent vs. 2 percent) and "persistent urge incontinence" -- the loss of urine just before feeling a strong, sudden urge to empty the bladder (27 percent vs. 20 percent).

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Moreover, 19 women with slings had difficulty voiding after treatment, requiring additional surgery to correct the problem. None of the women who underwent the Burch needed corrective surgery for voiding problems.

There are also new procedures that are variations on the sling, Albo noted. In these procedures a synthetic mesh is used to secure the urethra into position. The advantages of these new techniques are that they require a smaller incision, and usually the patient can go home the same day as the procedure is done. For doctors, the mesh is easier to place than making a sling from the patients own flesh, he said.

Albo said studies are under way comparing these newer procedures to both the standard Burch and sling.

"We are in the middle of trials looking at new procedures," added co-author Dr. Linda Brubaker, a professor of obstetrics/gynecology and urology at Loyola University. "These newer procedures are becoming more common," she said.

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