A Randomized Prospective Study of Three Operative Methods for Genuine Stress Incontinence

ABSTRACT One hundred seventy women with clinical and urodynamic findings of genuine stress incontinence (GSI) and pelvic relaxation were randomly selected to be surgically treated by the authors with one of the following methods: anterior colporrhaphy (AC), Marshall-Marchetti-Krantz (MMK) operation, or Burch colposuspension. The patients were examined clinically and urodynamically 2 months and 60 months after the operation. Clinical and urodynamic study showed no statistical differences in the first 2 months (cure rate 95%, 78%, 85% for Burch colposuspension, AC, and MMK respectively). There was a significant difference in the therapeutic result for the 3 methods after 60 months. Burch colposuspension had better results (89%), whereas AC and MMK had 56% and 67% cure rates, respectively (p < 0.001). Burch colposuspension achieved better suspension of the bladder base, neck, and proximal urethra, as confirmed after transvaginal sonography, in comparison with the other methods. Spontaneous voiding was satisf...