ORIGINAL ARTICLE Long-term clinical outcomes with the retropubic tension-free vaginal tape (TVT) procedure compared to Burch colposuspension for correcting stress urinary incontinence (SUI) Bjørn Holdø 1 & Margareta Verelst 2 & Rune Svenningsen 3 & Ian Milsom 4 & Finn Egil Skjeldestad 5 Received: 23 October 2016 /Accepted: 27 February 2017 # The International Urogynecological Association 2017 Abstract Introduction and hypothesis The retropubic tension-free vaginal tape (TVT) procedure replaced Burch colposuspension as the primary surgical method for stress urinary incontinence (SUI) and mixed urinary in- continence (MUI) in women in our department in 1998. In this study we compared the short-term and long-term clinical outcomes of these surgical procedures. Methods Using a case series design, we compared the last 5 years of the Burch procedure (n = 127, 1994–1999) with the first 5 years of the retropubic TVT procedure (n = 180, 1998–2002). Information from the medical records was trans- ferred to a case report form comprising data on perioperative and long-term complications as well as recurrence of UI, defined as bothersome UI or UI in need of repeat surgery. Other endpoints were rates of perioperative and late compli- cations and the rates of prolapse surgery after primary surgery. The data were analyzed with the chi-squared and t tests and survival analysis using SPSS. Results The cumulative recurrence rate of SUI in women with preoperative SUI was significantly higher after the Burch procedure, but no difference was observed in women with MUI. There were no significant differences in rates of perioperative and late complications. At 12 years there was a significant increase in rates of repeat surgery for incontinence and prolapse in women after the Burch procedure. Conclusions The long-term efficacy of TVT surgery was su- perior to that of Burch colposuspension in women with SUI. In addition, the rate of late prolapse surgery was significantly higher after the Burch procedure. Keywords Burch colposuspension . Complications . Long-term results . Midurethral slings . Mixed urinary incontinence . Stress urinary incontinence Introduction Until the late 1990s Burch colposuspension was considered the gold standard in the surgical treatment of stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) in women [1]. The surgery is an open procedure requiring general or regional anesthesia, and involves a hospital stay of 7–10 days followed by sick leave of 3–4 weeks. In 1995 Ulmsten et al. described the retropubic tension-free vaginal tape (TVT) as a new surgical treatment for female urinary incontinence (UI) [2]. The TVT operation is an outpatient procedure performed under local anesthesia, requiring sick The abstract of this work was presented as a poster presentation at the 40th Nordic Congress of Obstetrics and Gynecology, Helsinki, 12–15 June 2016, and at the Annual Assembly of the Norwegian Association of Gynecology and Obstetrics, Lillestrøm, 26–28 October 2016. Key message TVT is superior to Burch colposuspension for treatment of SUI. * Bjørn Holdø bjorn.holdo@yahoo.no 1 Department of Obstetrics and Gynecology, Nordland Hospital, Parkveien 95, 8005 Bodø, Norway 2 Division of Surgery, Oncology and Women’s Health, University Hospital of North Norway, Tromsø, Norway 3 Department of Obstetrics and Gynecology, Oslo University Hospital, Ullevål, Oslo, Norway 4 Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden 5 Institute of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway Int Urogynecol J DOI 10.1007/s00192-017-3345-0