Abstract
The aim of this study was to evaluate the effect of concomitant vaginal hysterectomy with modified four-corner suspension for the treatment of advanced genitourinary prolapse and stress urinary incontinence. Twenty-five patients with genuine stress incontinence and advanced genitourinary prolapse underwent concomitant vaginal hysterectomy and Raz four-corner suspension with approximation of bilateral pubocervical fasciae. The surgical results were assessed using the urodynamic study, the 1-hour pad test, and the bladder diary, 6 months postoperatively. Each patient was asked to return for an assessment of pelvic support every 6 months. The average length of follow-up was 26.3 months. Clinical evaluation of urinary incontinence showed that 21 (84%) patients were cured. Twenty-one patients received postoperative urodynamic investigation, and 17 (81%) were found normal. The results of this study suggest that concomitant vaginal hysterectomy and four-corner suspension with approximation of bilateral pubocervical fasciae provide a good opportunity to correct advanced genitourinary prolapse and stress incontinence.
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