Combination of two anti-stress procedures: our original 4-corner deltoid-like vaginal suspension and suburethral duplication sec. Lazarevski in patients with genital prolapse.

Aim: The effectiveness of the combination of two anti-stress procedures: 1) our original 4-corner deltoid-like vaginal suspension; and 2) suburethral duplication sec. Lazarevski are analysed.

Study Design: 144 women, undergoing vaginal hysterectomy, combined with our original 4-corner deltoid-like vaginal suspension and suburethral duplication sec. Lazarevski were divided into: SUIGP group (n = 48) with stress urinary incontinence (SUI) and genital prolapse (GP); and GP group (n = 96) with GP. All operations were performed by the first author of this study.

Results: At the last follow-up (mean 18.3 months for GP, and 18.7 months for SUIGP), point C was significantly higher in both groups and total vaginal length (tvl) longer in GP vs. preoperative positions (p < 0.05; p < 0.05; p < 0.05 respectively). There were no postoperative significant differences between groups. Regarding the severity of prolapse: stage I for anterior segment and stage 0 for most severe segment predominated in SUIGP (p < 0.05; p < 0.05 respectively). The recurrent prolapse was: 1) in anterior segment: stage I 6.25% in GP and 18.7% in SUIGP; stage II 6.25% in GP and 2.1% in SUIGP; 2) in posterior segment: stage I 18.7% in GP and 18.7% in SUIGP. There was no recurrent prolapse of the apical segment, and only one patient with stage III anterior segment. The recurrent SUI was 8.3% in SUIGP, and de novo SUI 1% in GP.

Conclusion: This proposed combination seems to be safe and effective (Tab. 8, Fig. 2, Ref. 24). Full Text (Free, PDF) www.bmj.sk.