title: Urogenital prolapse--current methods of surgical treatment.
abstract: Several combined surgical procedures have been described, but connective tissue deficiency required the use of some "prostheses" instead of conventional methods based exclusively on correction by suture.
  
  
  OBJECTIVE
  Assessment of the techniques used for the repair of stress urinary incontinence (SUI) and anterior vaginal wall prolapse, as well as the incidence of intraoperative and postoperative incidents and complications.
  
  
  METHODS
  The study was conducted between January 2007 and December 2011 at the 1st Clinic of Obstetrics and Gynecology Iaşi. The diagnosis was made on clinical criteria. Menopausal patients received estrogens prior to surgery. Vaginal meshes were used only in patients with grade III and IV cystocele. The patients were followed up at 1 1/2, 6, 12 and 36 months (first local evaluation for meshes at 2 weeks after surgery).
  
  
  RESULTS
  During the study interval 400 patient with a mean age of 57.45 ± 5 years (range 29-81 years) were surgically treated in our clinic. Of these, 150 women underwent classic surgery, 243 women transobturator tape procedure-TOT (107 TOT alone for SUI and 136 TOT combined with classic surgery), 4 women ten- sion-free vaginal tape (TVT) procedure, and 3 patients prepubic and transobturator mesh. In 12 patients meshes with 2 or 4 arms for cystocele (7 and 5 cases, respectively) were used. Vaginal mesh extrusion was recorded in 4 patients.
  
  
  CONCLUSIONS
  The use of prostheses allows a better standardization of procedures, shortening of surgical time and a better postoperative recovery, the patients being able to resume their normal activities.
authors.forename: Mihaela-Camelia
authors.initials: MC
authors.lastname: Tirnovanu
authors.forename: Monica Holicov
authors.initials: MH
authors.lastname: Luţuc
authors.forename: Angelica Ciucanu
authors.initials: AC
authors.lastname: Mătrescu
authors.forename: M
authors.initials: M
authors.lastname: Onofriescu
authors.forename: Ecaterina
authors.initials: E
authors.lastname: Dalas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology; D013520:Urologic Surgical Procedures / Q000379:methods*; D014596:Uterine Prolapse / Q000601:surgery