Surgical Arms
Arm A · n = 104
Sacrocolpopexy + Burch
Abdominal sacrocolpopexy with Burch colposuspension
Arm B · n = 111
Sacrocolpopexy Alone
Abdominal sacrocolpopexy without Burch
POP Failure at 7 Years (Updated Anatomic Definition)
27%
Burch — Anatomic POP Failure
Updated definition
22%
No Burch — Anatomic POP Failure
Updated definition
0.050
Difference
95% CI −0.161, 0.271 — NS
Composite POP Failure Trajectory
| 2 yr | 3 yr | 5 yr | 7 yr |
| Burch |
0.22 | 0.29 | 0.39 | 0.48 |
| No Burch |
0.18 | 0.23 | 0.29 | 0.34 |
SUI Outcomes at 7 Years
62%
Burch SUI Failure
at 7 years
77%
No Burch SUI Failure
at 7 years
3.3×
Burch Delayed SUI Onset
131.3 vs 40.2 months
−0.153
Difference (Significant)
95% CI −0.268, −0.030
Mesh Erosion: Probability 10.5% (95% CI 6.8–16.1%) at 7 years. 23 women total. New erosions continued appearing throughout follow-up. 15/23 required OR excision. Mandates long-term surveillance.
Additional Surgeries: At least 36/215 (16.7%) had additional pelvic floor surgery by year 7: 11 POP, 14 SUI, 11 mesh complications.
Clinical Bottom Line
Sacrocolpopexy provides durable symptom relief (95% no POP retreatment at 7 years) despite rising anatomic failure (~27%). Burch delays but does not eliminate SUI (62% vs 77% failure at 7yr). The 10.5% mesh erosion rate with ongoing new erosions mandates long-term surveillance and informed consent counseling.