Role of the four-corner bladder neck suspension to correct stress incontinence with a mild to moderate cystocele.
OBJECTIVE
Women undergoing four-corner bladder neck suspension were evaluated for subjective and objective results of the procedure. Patients were evaluated for continence, prolapse, and symptomatic status postoperatively.


METHODS
Forty-seven women underwent four-corner bladder neck suspension for moderate cystocele with (44) or without (3) stress urinary incontinence. Mean and median follow-up were 37 months (range 15 to 80). To assess results of the four-corner bladder neck suspension, two sets of outcome measures were used (subjective questionnaire, including patient satisfaction, and objective physical examination, with standing voiding cystourethrogram) to compare pre- and postoperative data.


RESULTS
At the time of follow-up, 25 patients (53%) reported no incontinence, 14 (30%) reported one incontinent episode per week, and 8 (17%) reported daily loss of urine. Twenty-seven (57%) had grade I or grade II cystoceles on follow-up examination and voiding cystourethrogram; however, only 12 (26%) experienced recurrent prolapse symptomatology. Overall patient acceptance of the procedure was high (70%).


CONCLUSIONS
The four-corner bladder neck suspension is an effective option in the management of moderate cystocele.
Dmochowski
R R
RR
Department of Urology, University of Tennessee, Memphis 38168, USA.
Zimmern
P E
PE
Ganabathi
K
K
Sirls
L
L
Leach
G E
GE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D013537:Sutures; D001745:Urinary Bladder Diseases / Q000150:complications / Q000628:therapy*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000628:therapy*