Risk of recurrent stress incontinence in women undergoing the combined modified pereyra procedure and transvaginal sacrospinous ligament vault suspension.
OBJECTIVE
To determine the risk of recurrent stress urinary incontinence in women undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension.


METHODS
A retrospective analysis of 62 patients who underwent the modified Pereyra procedure at Harbor-UCLA Medical Center between October 1, 1993 and July 10, 1999 for stress urinary incontinence was performed.


RESULTS
The study group consisted of 62 patients treated for stress incontinence; 34 (55%) of the 62 patients underwent the modified Pereyra procedure for stress incontinence, and 28 (45%) underwent the combined modified Pereyra procedure and sacrospinous ligament vault suspension for stress incontinence and coexistent uterine and/or vaginal vault prolapse. Patients undergoing the modified Pereyra procedure without vaginal vault suspension had higher subjective (91% versus 64%, P = 0.01) and objective (88% versus 61%, P = 0.02) cure rates of stress urinary incontinence compared with the patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension. The mean follow-up period for the patients undergoing the modified Pereyra procedure (23 +/- 14.4 months) was similar to that of the patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension (26 +/- 9.4 months) (P = 0.3). Compared with the objectively cured patients, patients with objective failure demonstrated postoperative bladder neck hypermobility and a higher rate of recurrent grade 2 or greater anterior vaginal prolapse. Eleven patients had postoperative detrusor instability, and 2 patients who underwent sacrospinous ligament vault suspension developed recurrent grade 3 apical vault prolapse.


CONCLUSIONS
Patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension have high rates of recurrent stress urinary incontinence.
Nguyen
J K
JK
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, University of California, Los Angeles, School of Medicine, Los Angeles, California, USA
Bhatia
N N
NN
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008022:Ligaments / Q000601:surgery; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014596:Uterine Prolapse / Q000601:surgery*