Anatomical and subjective short-term outcomes of transperineal tape procedures and Burch colposuspension: a prospective ultrasound study

To compare the short-term (three-month) anatomical alterations and subjective outcomes of transobturator tape (TOT), tension-free vaginal tape (TVT), and Burch colposuspension using transperineal ultrasound (TPUS).
This prospective observational study, reported in accordance with TREND guidelines, included 80 women with stress urinary incontinence (SUI) (TOT: n = 30; TVT: n = 30; Burch: n = 20) assigned based on institutional protocols. Pre- and postoperative assessments included TPUS (alpha/beta angles, bladder neck descent) and validated questionnaires (UDI-6, IIQ-7). Multivariate regression models were utilised to adjust for baseline age, BMI, and parity.
All procedures resulted in significant intra-group anatomical and symptomatic improvements (p < 0.05). In adjusted analyses, the TVT procedure was associated with a significantly greater reduction in the alpha angle (p = 0.046). Furthermore, TVT showed a statistically significant association with greater UDI-6 score improvement compared with the Burch procedure (Adjusted OR: 0.04; 95% CI: 0.003–0.71; p = 0.032). Non-responder analysis confirmed that attrition bias was minimal (p > 0.05).
TOT, TVT, and Burch procedures are all effective in providing significant short-term restoration of anatomy and symptoms. While TVT demonstrated more pronounced anatomical and subjective gains in adjusted models, clinical satisfaction remains high across all techniques. Findings should be interpreted with caution due to the observational design and short follow-up.
Stress urinary incontinence (SUI) is the unintentional leakage of urine during physical activities such as coughing, sneezing, or exercise. It is a common condition that significantly affects a woman’s quality of life. While several surgical treatments exist—including the TOT and TVT “tape” procedures and the Burch colposuspension—there is limited information comparing how each method changes the internal anatomy and how these changes relate to patient satisfaction.
We followed 80 women undergoing one of these three surgical treatments. To look at the internal changes without causing discomfort, we used a non-invasive method called transperineal ultrasound (TPUS). This involves placing an ultrasound probe on the outside of the body rather than internally. We measured the position and angles of the bladder and urethra both before the surgery and three months after.
Our results showed that all three surgical procedures are highly effective. Every group experienced significant improvements in their symptoms and overall quality of life. While the TVT procedure was slightly more effective at restoring the anatomical angle of the bladder neck, this did not mean those patients were “happier” than others; women in all three groups reported similar, high levels of satisfaction. We also found that differences in the number of previous births did not appear to explain the differences in surgical outcomes.
This study suggests that surgeons have three reliable options to offer patients, as TOT, TVT, and Burch procedures all provide excellent short-term results. It also highlights that transperineal ultrasound is a safe, painless, and effective tool for doctors to monitor surgical success and ensure the treatment is working as intended.