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By Andrea Hughes, Ivanhoe Health Correspondent
ORLANDO, Fla. (Ivanhoe Newswire) -- Many women suffering from urinary incontinence may be able to find relief soon. A new study compared two commonly performed surgical procedures that treat stress incontinence to find out which procedure is more effective.
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Michael Albo, M.D., lead study author and co-director of the University of California, San Diego Women's Pelvic Medicine Center, "Women are at risk for stress incontinence because of anatomy, and the fact that the urethra is much shorter and requires the support of the pelvic muscles to prevent the urine from leaking. If this support is injured or becomes weakened, then they're more vulnerable for stress incontinence." Stress incontinence develops when those supports are weakened, and the bladder moves down toward the bottom of the pelvis. Physical changes due to pregnancy, childbirth and menopause can also cause incontinence.
Stress urinary incontinence occurs when urine leaks out and can take place during bouts of laughter, coughing, sneezing, running or when lifting heavy objects. The study, known as SISTEr (the Stress Incontinence Surgical Treatment Efficacy Trial), compares the fascial sling with the Burch colposuspension technique. In the sling procedure, a strip of the patient's tissue is placed under the urethra and attached to the ligaments of the pubic bone to provide support, like a hammock. In the Burch procedure, the urethra and bladder are lifted, put back into place and secured with sutures to tissue near the pubic bone.
The study followed women who received both treatments and studied the success rates. Two years after surgery, 520 women completed assessments of their outcomes. Overall success rates were 47 percent for the sling procedure and 38 percent for those who underwent the Burch procedure. Although people seemed more satisfied with the sling procedure, side effects were slightly higher. Some women who had the sling procedure had higher instances of urinary tract infections, and some had difficulty urinating. Urinary tract infections occurred in 63 percent of women with a sling compared to 47 percent of women in the Burch group. Also, 19 women had trouble urinating after the sling procedure and required more surgery to correct the problem compared to no women in the Burch group needing corrective surgery.
This is the first rigorous study of its kind. Dr. Albo says, "I think that the other thing that this study demonstrates is that incontinence trials are feasible, and this kind of evidence contributes to overall care." He also says, "Incontinence is a highly individual experience," and a corrective procedure should be discussed with a physician and should also be chosen based on that individual's goals.
This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.
SOURCE: Ivanhoe interview with Michael Albo, M.D.; presented at the annual meeting of the American Urological Association, May 21, 2007
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