V.I. Gorovyy
The place of retropubic colpopexy and colposuspension in surgical treatment of female stress urinary incontinence
To estimate indications and contraindications to retropubic colpopexy and colposuspension in surgical treatment of female stress urinary incontinence and compare early and late results of retrobupic operations. Materials and methods. For the last 35 years (1977-2011) in urologic department of Vinnitsa Regional Hospital 64 retropubic operations were performed in female with stress urinary incontinence: 35 - Marshall-Marchetti-Krantz operations in Antonov’s modification (retropubic colpopexy), 2 - Burch operation (retropubic colposuspension), 27 -combined Marchall-Marchetti-Krantz and Burch method (retropubic colpopexy and colposuspension). Early and late results of Marchall-Marchetti-Krantz operations in Antonov’s modification (35 patients) and combined Marchall-Marchetti-Krantz-Burch operations (25 patients) were analyzed. The average age of patient who were operated by MMK-Antonov’s method (I group) was 51.3 year, MMK-Burch method (II group) was 52.4 year. Cystocele (I-st grade) was noted in 4 (11.4%) patients of I group and in 3 (12%) patients of II group.
Results and discussion. Immediate postoperative complications, especially dysuria, were noted statistically less frequently after MMK-Burch operation (4%) than after MMK-Antonov’s operation (28.6%).The less complication rate in the group II was due to technique of putting the sutures on anterior vaginal wall in distance from urethra without capturing of external layer of urethra. There were not statistically differences between late results of operations.
Conclusions. Combining the principles operation MMK and Burch in surgical treatment female stress urinary incontinence permits reliable fixing and suspending of vagina in high retropubic position, preventing retention of urine and dysuria symptoms in early postoperative period, disorder of urethral sphincter function with recurrence urine incontinence in late postoperative period.