Objective: The evaluation of the success rate after the Burch colposuspension in obese and non obese patients with genuine stress incontinence. Design: Prospective clinical trial. Setting: Obstetrics and Gynaecology Department, Charles University 2 nd Medical School and Faculty Hospital Motol, Prague. Methods: A group of 26 obese and 56 non obese patients who underwent Burch colposuspension in 1997 and 1998 were studied. Preoperative and postoperative examination consisted of clinical history, physical examination, BMI, urodynamic evaluation, Q-tip test, stress test, age, menopausal status, duration of incontinence before surgery, lenght of follow-up, symptoms of urgency after surgery, postoperative complications and restoration of the micturition after procedure. Both objective parameters and subjective assessment were included in the postoperative evaluati- on of surgical treatment. c 2 test, Mantel-Haenszel version was used for statistical analysis and exact Fisher test for low-frequency-cases in table enclosed. Computation was realised by System EPIINFO version 6. Results: The continence rate after intermediate follow-up in the group of 26 obese patients was 84,6% and the success rate in the group of 56 non obese was 87,5%. The difference between the results of both groups were not statistically significant. The operations were somewhat more difficult to perform due to the body habitus of the obese patients but there were no intraoperative complications and only 1 patient had serious wound infection postoperatively. Conclusions: Obese women with stress urinary incontinence can undergo Burch colposuspension with a good chance of success. Statistically important differences in mid-term follow-up of treatment successfulness of obese and non obese women have not been demonstrated. We recommend complete evaluation to ensure proper classification of the urinary incontinence. Burch colposuspension performed by experienced surgeon is a safe and efficacious procedure in the surgical treatment of obese patients with genuine stress incontinence.

        Key words: Burch colposuspension, genuine stress incontinence, obesity, BMI, unsuccesful treat- ment, Intermediate follow-up