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Comparison of anterior colporrhaphy and retropubic urethropexy for patients with genuine stress urinary incontinence.
Am J Obstet Gynecol. 1995 Dec; 173(6):1671-4; discussion 1674-5.AJ

Abstract

OBJECTIVE

Our purpose was to compared the efficacy of anterior colporrhaphy and retropubic urethropexy performed for genuine stress urinary incontinence.

STUDY DESIGN

A retrospective analysis was performed on women who underwent either anterior colporrhaphy or retropubic urethropexy for genuine stress urinary incontinence. Patients were identified by a computer-assisted search, and these women were contacted by telephone. The interview was used to assess current continence status. Variables reviewed included demographic data, medications, hormonal status, current smoking history, significant medical and surgical history, and time to recurrence of incontinence. Operative procedure, prior or concomitant hysterectomy, history of previous incontinence procedures, concomitant surgery for repair of other pelvic floor defects, experience level of the primary surgeon, and duration of postoperative catheterization were also documented.

RESULTS

Seventy-six women who had undergone surgery for genuine stress incontinence during a 4-year period were identified and evaluated by telephone interview. Fifty-six had undergone anterior colporrhaphy and 20 retropubic urethropexy. Both groups of patients were comparable in age, social status, race, parity, and weight. The duration of follow-up (mean +/- SD) was 66.6 +/- 14.2 months (range 48 to 96 months). Concurrent surgery to repair other pelvic floor defects was more common in patients undergoing anterior colporrhaphy than in patients undergoing retropubic urethropexy (p < 0.05). Of the 56 patients treated with anterior colporrhaphy, 26 (46%) were continent at the time of interview versus 15 of 20 (75%) treated with retropubic urethropexy (p < 0.05). Times to recurrence for anterior colporrhaphy and retropubic urethropexy were not significantly different. History of previous incontinence procedures, concomitant hysterectomy, previous hysterectomy, duration of postoperative catheterization, obesity, chronic lung disease, and smoking were not correlated with success for either procedure. Experience of the primary surgeon did have a significant effect on success, with attending staff having a better cure rate than resident surgeons (p < 0.05).

CONCLUSION

Retropubic urethropexy was significantly more effective than anterior colporrhaphy for long-term cure of genuine stress urinary incontinence. We believe these conclusions should be tempered because of the complex nature of genuine stress incontinence. Patients having anterior colporrhaphy may represent a high-risk group because nearly all of them had associated pelvic floor defects. Experience of the surgeon seems to enhance the likelihood of success and may reflect subtle modifications of technique.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8610743

Citation

Harris, R L., et al. "Comparison of Anterior Colporrhaphy and Retropubic Urethropexy for Patients With Genuine Stress Urinary Incontinence." American Journal of Obstetrics and Gynecology, vol. 173, no. 6, 1995, pp. 1671-4; discussion 1674-5.
Harris RL, Yancey CA, Wiser WL, et al. Comparison of anterior colporrhaphy and retropubic urethropexy for patients with genuine stress urinary incontinence. Am J Obstet Gynecol. 1995;173(6):1671-4; discussion 1674-5.
Harris, R. L., Yancey, C. A., Wiser, W. L., Morrison, J. C., & Meeks, G. R. (1995). Comparison of anterior colporrhaphy and retropubic urethropexy for patients with genuine stress urinary incontinence. American Journal of Obstetrics and Gynecology, 173(6), 1671-4; discussion 1674-5.
Harris RL, et al. Comparison of Anterior Colporrhaphy and Retropubic Urethropexy for Patients With Genuine Stress Urinary Incontinence. Am J Obstet Gynecol. 1995;173(6):1671-4; discussion 1674-5. PubMed PMID: 8610743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of anterior colporrhaphy and retropubic urethropexy for patients with genuine stress urinary incontinence. AU - Harris,R L, AU - Yancey,C A, AU - Wiser,W L, AU - Morrison,J C, AU - Meeks,G R, PY - 1995/12/1/pubmed PY - 1995/12/1/medline PY - 1995/12/1/entrez SP - 1671-4; discussion 1674-5 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 173 IS - 6 N2 - OBJECTIVE: Our purpose was to compared the efficacy of anterior colporrhaphy and retropubic urethropexy performed for genuine stress urinary incontinence. STUDY DESIGN: A retrospective analysis was performed on women who underwent either anterior colporrhaphy or retropubic urethropexy for genuine stress urinary incontinence. Patients were identified by a computer-assisted search, and these women were contacted by telephone. The interview was used to assess current continence status. Variables reviewed included demographic data, medications, hormonal status, current smoking history, significant medical and surgical history, and time to recurrence of incontinence. Operative procedure, prior or concomitant hysterectomy, history of previous incontinence procedures, concomitant surgery for repair of other pelvic floor defects, experience level of the primary surgeon, and duration of postoperative catheterization were also documented. RESULTS: Seventy-six women who had undergone surgery for genuine stress incontinence during a 4-year period were identified and evaluated by telephone interview. Fifty-six had undergone anterior colporrhaphy and 20 retropubic urethropexy. Both groups of patients were comparable in age, social status, race, parity, and weight. The duration of follow-up (mean +/- SD) was 66.6 +/- 14.2 months (range 48 to 96 months). Concurrent surgery to repair other pelvic floor defects was more common in patients undergoing anterior colporrhaphy than in patients undergoing retropubic urethropexy (p < 0.05). Of the 56 patients treated with anterior colporrhaphy, 26 (46%) were continent at the time of interview versus 15 of 20 (75%) treated with retropubic urethropexy (p < 0.05). Times to recurrence for anterior colporrhaphy and retropubic urethropexy were not significantly different. History of previous incontinence procedures, concomitant hysterectomy, previous hysterectomy, duration of postoperative catheterization, obesity, chronic lung disease, and smoking were not correlated with success for either procedure. Experience of the primary surgeon did have a significant effect on success, with attending staff having a better cure rate than resident surgeons (p < 0.05). CONCLUSION: Retropubic urethropexy was significantly more effective than anterior colporrhaphy for long-term cure of genuine stress urinary incontinence. We believe these conclusions should be tempered because of the complex nature of genuine stress incontinence. Patients having anterior colporrhaphy may represent a high-risk group because nearly all of them had associated pelvic floor defects. Experience of the surgeon seems to enhance the likelihood of success and may reflect subtle modifications of technique. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/8610743/Comparison_of_anterior_colporrhaphy_and_retropubic_urethropexy_for_patients_with_genuine_stress_urinary_incontinence_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9378(95)90408-5 DB - PRIME DP - Unbound Medicine ER -