Vaginal hysterectomy allied with Kelly-Kennedy surgery and perineal repair for the treatment of patients with a prolapsed uterus and urinary stress incontinence.
OBJECTIVE
To evaluate patients with uterine prolapse, before and after surgical treatment, using urodynamic and bladder neck ultrasound.


METHODS
33 postmenopausal patients with uterine prolapse were submitted to vaginal hysterectomy (Mayo-Ward technique) allied with Kelly-Kennedy surgery and perineal repair. The women were divided into three groups depending on the degree of prolapse. A urodynamic examination was performed before, after 30 days and in the third month after the operation. A bladder neck ultrasound was performed before and in the third month after the operation.


RESULTS
In 23 women who lost urine preoperatively, 14 continued to show objective loss 90 days after the surgery. Ultrasound identified a significant elevation in the bladder neck during rest in groups I and II, but not in group III. There was a significant reduction in its mobility in all three groups.


CONCLUSIONS
Kelly-Kennedy surgery does not have any indication, even in patients with urinary stress incontinence and a prolapsed uterus who are submitted to vaginal hysterectomy.
Kayano
C E
CE
Federal University of São Paulo, Brazil.
Sartori
M G F
MG
Baracat
E C
EC
de Lima
G Rodrigues
GR
Girão
M J B C
MJ
D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007045:Hysterectomy, Vaginal; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*