Objective To review the outcome of women who underwent Burch colposuspension 10 to 20 years ago and to assess factors which affect long term success. Design Longitudinal retrospective study. Setting Urogynaecology Unit, St George's Hospital, London. Subjects One hundred and nine women with genuine stress incontinence. Main outcome measures Survival analysis of subjective and objective cure of stress incontinence. Results Cure of incontinence following Burch colposuspension is time‐dependent, with a decline for 10 to 12 years when a plateau of 69% is reached. Factors adversely affecting cure are previous bladder neck surgery (logrank test P= 0.02), pre‐operative weight greater than 80 kg, intra‐operative blood loss more than 1000 ml and the development of post‐operative detrusor instability. Post‐operative complications included de novo detrusor instability (14.7%), long term complaints of voiding difficulty with objective recovery at the final follow up (22%) and recurrent urinary tract infection (4.6%). Conclusions Long term follow up after colposuspension is necessary to assess sequelae. We suggest that new continence procedures should be followed up for 5 to 10 years.

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Background and Objectives Vaginal pixelated low power and long pulses (LPLP) CO2 laser has been suggested as an optional treatment for stress urinary incontinence (SUI) with many studies reporting short‐term improvements. The objective of this study was to assess the 1‐year subjective and objective efficacy of vaginal CO2 laser in women with urodynamic SUI. Study Design/Materials and Methods This was a prospective multicenter study. Patients with confirmed urodynamic SUI graded as mild or moderate were included. We used three sessions of fractional pixelated CO2 laser for vaginal application and followed up the patients at 6 and 12 months. We used the following measures at follow‐up: 1‐hour pad test (ICS protocol), questionnaires including Pelvic Floor Distress Inventory 20 (PFDI‐20), Pelvic Floor Impact Questionnaire (PFIQ), Patient Global Impression of Improvement (PGI‐I), and a 3‐day urinary diary. The urodynamic assessment was repeated at 6 months. Results Fifty‐two patients with SUI had three laser treatments, of whom 48 completed a 6‐month follow‐up and 42 patients completed 12‐month follow‐up. No serious adverse events were recorded during the study period. A significant reduction on the 1‐hour pad test was found from baseline (6.3 ± 1.6 g) to the 12‐month follow‐up (3.7 ± 1.4 g, P < 0.05) was found. PGI‐I showed 75.0%, 61.9%, and 64.3% improvements at 3, 6, and 12 months, respectively. PFDI improved significantly and consistently from baseline until 12 months (37.2 ± 3.89 to 16.1 ± 3.7, P < 0.05). Similarly, PFIQ showed significant improvements from the first treatment up to 12 months. Urodynamic assessment at 6 months showed that 41.4% of patients had no stress incontinence. Conclusion The vaginal CO2 laser was found to be effective for mild‐to‐moderate SUI over a follow‐up period of 1 year, according to a variety of objective and subjective parameters. The wide range of parameters enables optimal patient consultation and subsequent treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC