Failure to predict and attempts to explain urinary stress incontinence following vaginal repair in continent women by using a modified lateral urethrocystography.
Of continent women undergoing the Manchester procedure for genito-urinary prolapse, about 25% develop urinary stress-incontinence. In order to study whether this is due to pre-existing anatomical factors or to the surgical procedure itself, a prospective study was set up. Fifty-eight continent women operated on for genito-urinary prolapse, underwent urethrocystography prior to and 3 months following surgery. Sixteen of the 58 (28%) developed stress-incontinence following the operation. Radiological parameters preoperatively were of little help in distinguishing the patients developing incontinence from those remaining continent. The stress-incontinence following a Manchester procedure for genital prolapse seems to depend on two surgical factors: an insufficient elevation of the bladder-neck and a radical reduction of the cystocele. A parameter combining the two factors: the percentage reduction of the cystocele minus the percentage elevation of the bladder-neck, was significantly lower in women remaining continent than in those who developed stress-incontinence.
Borstad
E
E
Department of Gynecology and Obstetrics, Aker University Hospital, Oslo, Norway.
Skrede
M
M
Rud
T
T
D000368:Aged; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D014521:Urethra / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D001745:Urinary Bladder Diseases / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D014596:Uterine Prolapse / Q000601:surgery