Randomized Arms
Arm A · n = 326
Fascial Sling
Autologous rectus fascia pubovaginal sling
Arm B · n = 329
Burch
Modified Burch colposuspension
Primary Outcome: Overall Success at 24 Months
Key Outcomes
Differential Complications
Higher with Sling
Voiding dysfunction: 14% vs 2% (P < 0.001)
UTIs: 48% vs 32%
Urge incontinence Tx: 27% vs 20% (P = 0.04)
Higher with Burch
Incidental cystotomy: 10 vs 2
Ureteral injury: 2 vs 0
Retreatment rate: 11% vs 2%
Clinical Bottom Line
The autologous fascial sling is more effective than Burch colposuspension for stress incontinence (47% vs 38% overall; 66% vs 49% stress-specific) but carries higher morbidity — voiding dysfunction, UTIs, and urge incontinence. This trial predates midurethral synthetic slings and provides the benchmark against which newer procedures were compared.