Among the surgeries of stress incontinence, the long-term success rate is maximum with

Burch Colposuspension It corrects both stress urinary incontinence and cystocele Not suitable if vagina is narrowed or scarred by previous surgeries Surgery is performed by a low transverse suprapubic incision Procedure: Bladder, bladder neck and proximal urethra are dissected medially off the underlying paravaginal fascia and three or four pairs of non-absorbable or delayed absorbable sutures are inseed between the fascia and ipsilateral iliopectineal ligament This sutures elevates bladder neck and bladder base Disadvantages: Detrusor overactivity may occur denovo or maybe unmasked by the procedure Voiding difficulties may occur 85% success rate is balanced against development of enterocele and rectocele postoperatively It has been superseded by TVT Tape Ref: SHAW&;S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no:194