Burch colposuspension versus fascial sling to reduce urinary stress incontinence.
We were very interested to read the recent study by Welk and Herschorn, and the related commentary by Steele, regarding the role of autologous rectus fascial slings for complex recurrent female stress urinary incontinence (SUI).
Richter and her colleagues randomized women with stress urinary incontinence (SUI) to undergo treatment with either Burch colpopexy or autologous rectus fascial sling
in the Stress Incontinence Surgical Treatment Efficacy Trial (SISTER).
Autologous fascial sling vs polypropylene tape at short-term follow-up: a prospective randomized study.
The TOMUS study uses a composite primary outcome measure, with objective and subjective components, similar to the outcome measures utilized in the UITN's recently completed Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr) trial (23) comparing the Burch procedure to autologous fascial slings.
Autologous fascial sling (AFS) is an effective treatment for SUI that has longevity and may be more effective than other biological and synthetic slings (grade A).
Retropubic MUS is more effective than Burch colposuspension, but equally as effective as fascial slings (level of evidence 2) (Table 1).