Occurrence of stress urinary incontinence in women after surgical repair of pelvic organ prolapse with use Gynecare Prolift System

Repair surgery for pelvic organ prolapse (POP) may unmask occult stress urinary incontinence in many women. The limited evidence suggests 11-22% of continent patients with severe pelvic organ prolapse will develop postoperative stress urinary incontinence. The objective of this study was to assess pelvic floor function with regard to stress urinary incontinence (SUI) after repair of severe pelvic organ prolapse with use Gynecare Prolift System.
Methods: The present retrospective study 62 patients who underwent repair surgery between December 2006 and April 2009. All women had a genital prolapse – III or IV according to POPQ classification. According to each case, prosthetic interposition was total, or anterior only, or posterior only. Subjective outcome was measured using the stress test and postal questionnaire postoperatively.
Results: The mean age of patients was 61.9 years (46-79). 82.4% of patients were post-menopause, 14.5% had previously hysterectomy. Among 62 women, 33 (53.2%) were treated for a prolapse touching both, anterior and posterior wall, 20 (32.2%) had a cystocoele only and 9 (14.5%) was diagnosed for a rectocoele. SUI was diagnosed preoperatively in 19 women (37.2%).The mean follow-up period was 8.5 months. Among 62 operated woman, we obtained back by post 51 (82.2%) filled in questionnaire. The incidents of stress urinary incontinence were frequent in 29.4% cases after Prolift System procedure. 10 patients, among 19 with previously symptoms of SUI, showed improvement. In 6 women (11.8%), SUI was appeared de novo. The rate of SUI did not differ between pre- and postoperatively women with POP. In conclusion, surgery with mesh repair did not improved urinary continence in women with severe pelvic organ prolapse.