Vaginal Surgery for Genital Prolapse Associated with Stress Urinary Incontinence: A Retrospective Study

This is a retrospective analysis of the results obtained in 60 cases of urogenital prolapse associated with either medium (stress test grade III) or severe-stress (stress test grade IV) stress urinary incontinence (SUI) who underwent vaginal hysterectomy, anterior colporraphy, plication of the posterior pubourethral ligaments, and colpoperineorraphy. The surgical, anatomic, and functional outcome was evaluated in the long term during a median follow-up period of 32 months. One year after surgery, the anatomy of the vaginal profile was successfully restored in 90% of patients. The cure rate of the patients with grade III stress test was 96% at the 2-month postsurgical evaluation, 90% after 1 year, and 76% after two years. The cure rate of the patients with grade IV stress test was 80% at the 2-month postsurgical evaluation, but the 1-year cure rate was reduced to 68% and fell further to 52% after 2 years. We conclude that although these data do not reach statistical significance, an exclusively vaginal approach may be satisfactory as cure of genital prolapse associated with moderate SUI, while in the case of associated severe SUI, the success rate is unacceptably law. Nevertheless, because of its simplicity, a vaginal procedure is still the most favored solution for patients in poor general conditions.