A clinical and urodynamic assessment of the Burch colposuspension for genuine stress incontinence.

Twenty-five women having a Burch colposuspension operation were assessed before and after the operation by urodynamic investigations including urethral pressure measurements at rest and on stress. After 3 months, the objective cure rate was 88%. An increase in voiding difficulty and urodynamic evidence of outflow obstruction was seen after the operation. The operation does not induce any significant change in resting urethral profile variables. The stress profile showed accentuation in pressure transmission ratios, most marked in the proximal urethra. These changes are likely to be mechanical in origin and may be responsible for voiding difficulties in those women who initiate voiding by straining.