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Introduction: Stress urinary incontinence (SUI) is a common condition affecting up to 50% of older women and 20–30% of premenopausal women, significantly impacting quality of life. While Burch colposuspension (BC) has shown long-term efficacy rates of 65–90%, up to 28% of patients (pts) experience adverse events.

Methods: This study assessed BC procedures performed via mini-laparotomy (2020–2023) by a single urogynecological surgeon at University Hospital Bonn. The study aimed to determine the effect of BC for the treatment of SUI in women. Objective outcomes included a stress test and 24-hour pad usage, while subjective outcomes were evaluated using the German Pelvic Floor Questionnaire (GPFQ) and the International Consultation of Incontinence Questionnaire (ICIQ).

Follow-up examinations were performed at 8-12 weeks (FU1) and at the timing of last clinical follow-up (FU2a). A study-specific questionnaire (SSQ), GPFQ and ICIQ were sent to all pts between December 2023 and May 2024 (FU2b). Secondary aims were to assess the safety of BC and identify predictors of surgical failure.

Results: Among 115 BC procedures, the domains bladder, prolapse and sexual function regarding GPFQ were significantly reduced at FU1 compared to preoperatively. 81% of pts showed improvement or cure (ICIQ) at FU2a (mean 16 months). The positive stress test rate dropped significantly (22% to 3.5%, p < 0.05), as did pad usage (3 to 1, p = 0.05) between preoperatively and FU2a. At FU2a, 15.7% had persistent SUI, 23.5% reported urge symptoms, and bladder, prolapse, and sexual function regarding GPFQ improved significantly. At FU2b (mean 22 months), 81% were satisfied, and de novo urge symptoms occurred in 3.5%. Low preoperative urethral closure pressure was linked to higher failure risk.

Conclusion: BC is an effective treatment modality for SUI in women, offering high patient satisfaction, good short-term treatment success, and a low risk of adverse events.

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