Anatomical and subjective short-term outcomes of transperineal tape procedures and Burch colposuspension: a prospective ultrasound study.

BACKGROUND

To compare the short-term (three-month) anatomical alterations and subjective outcomes of transobturator tape (TOT), tension-free vaginal tape (TVT), and Burch colposuspension using transperineal ultrasound (TPUS).

METHODS

This prospective observational study, reported in accordance with TREND guidelines, included 80 women with stress urinary incontinence (SUI) (TOT: n = 30; TVT: n = 30; Burch: n = 20) assigned based on institutional protocols. Pre- and postoperative assessments included TPUS (alpha/beta angles, bladder neck descent) and validated questionnaires (UDI-6, IIQ-7). Multivariate regression models were utilised to adjust for baseline age, BMI, and parity.

RESULTS

All procedures resulted in significant intra-group anatomical and symptomatic improvements (p < 0.05). In adjusted analyses, the TVT procedure was associated with a significantly greater reduction in the alpha angle (p = 0.046). Furthermore, TVT showed a statistically significant association with greater UDI-6 score improvement compared with the Burch procedure (Adjusted OR: 0.04; 95% CI: 0.003-0.71; p = 0.032). Non-responder analysis confirmed that attrition bias was minimal (p > 0.05).

CONCLUSIONS

TOT, TVT, and Burch procedures are all effective in providing significant short-term restoration of anatomy and symptoms. While TVT demonstrated more pronounced anatomical and subjective gains in adjusted models, clinical satisfaction remains high across all techniques. Findings should be interpreted with caution due to the observational design and short follow-up.