SURGERY FOR PROLAPSE AND STRESS INCONTINENCE: VAGINAL HYSTERECTOMY WITH COLPORRHAPHY AND TENSION-FREE VAGINAL TAPE

K. Tamussino, MD, F. Zivkovic, MD, F. Moser, MD, V. Bjelic, MD, A. Bader, MD

   Objective: Surgery for stress incontinence is frequently performed concomitantly with surgery for pelvic organ prolapse. We evaluated the objective results of vaginal hysterectomy and prolapse repair with the tension-free vaginal tape (TVT) operation.

   Methods: Of 271 TVT operations performed at our institution between 1998 and 2001, 69 (25%) were done with vaginal hysterectomy and repairs. Preoperatively all 69 women had moderate to severe stress incontinence and stage II-IV uterovaginal prolapse; none had had previous surgery for prolapse or incontinence. Follow-up at 3-12 months consisted of clinical examination, cystometry to 300 mL, and a cough stress test.

   Results: 44/50 (88%) patients were objectively stress continent after TVT with prolapse surgery, compared with 122/148 (82%) of those undergoing TVT without prolapse surgery. The latter group included patients with previous surgery for incontinence, prolapse, or both. The median number of days until voiding with residuals <100 mL was 3 vs. 1 day, respectively.

   Conclusion: The TVT operation appears effective for curing stress incontinence in patients undergoing concomitant vaginal hysterectomy and colporrhaphy in the short to medium term.

   Key Words: Tension-free vaginal tape; Prolapse surgery