Abstract

Systematic Review

Burch Colposuspension for Female Stress Urinary Incontinence: A Narrative Review of Contemporary Evidence and Urodynamic Perspectives

Mohammed Amine Elafari*, Mamad Ayoub, Mohammed Amine Bibat, Amine Slaoui, Tarik Karmouni, Abdelatif Koutani and Khalid Elkhader

Published: 09 April, 2026 | Volume 10 - Issue 1 | Pages: 024-031

Background: Burch colposuspension is a mesh-free retropubic urethropexy for female stress urinary incontinence (SUI). Amidst increasing scrutiny of synthetic materials, re-evaluating its long-term efficacy and urodynamic profile is essential. 
Objective: To review contemporary evidence regarding the urodynamic mechanisms, clinical efficacy, and safety profile of the Burch procedure. 
Methods: A comprehensive literature search was conducted across PubMed, Cochrane Library, and Google Scholar for studies published up to 2025. We included randomized controlled trials, meta-analyses, and long-term cohort studies focusing on Burch colposuspension compared to midurethral slings and autologous slings. 
Results: Open colposuspension achieves objective cure rates of 68.9%–88% in the first year, with approximately 70% maintaining continence at five years. Long-term studies (mean 13.1 years) show comparable efficacy to midurethral slings (83% vs. 85%). The procedure restores continence by enhancing pressure transmission to the proximal urethra without altering intrinsic sphincter function. While autologous fascial slings offer higher stress-specific success (66% vs. 49%), they carry significantly higher risks of voiding dysfunction requiring reoperation (6.1% vs. 0%). Common complications of Burch include de novo overactive bladder (3%–4.1%) and a higher risk of posterior compartment prolapse (3.3%) compared to slings. 
Conclusions: Burch colposuspension remains a gold-standard, mesh-free intervention for women with urethral hypermobility, especially those undergoing concurrent abdominal surgery. It provides a durable, safe alternative to synthetic slings with a lower risk of obstructive voiding dysfunction, though patients should be counseled regarding potential long-term pelvic organ prolapse.

Read Full Article HTML DOI: 0.29328/journal.jcmei.1001045 Cite this Article Read Full Article PDF

Keywords:

Burch colposuspension; Stress urinary incontinence; Urodynamic stress incontinence; Urethral hypermobility; Intrinsic sphincter deficiency; Urodynamic testing; Retropubic surgery

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