EVALUATION OF LONG-TERM RESULTS OF SURGICAL-CORRECTION OF STRESS URINARY-INCONTINENCE

A total of 109 patients submitted to surgery for the correction of uri nary stress incontinence (USI) by two different techniques, i.e. anter ior colporrhaphy (group I, n = 57) when cystocele grade II/III was pre sent, and Burch procedure (group II, n = 52) when cystocele grade I wa s present, were reevaluated an average of 5 years after surgery (range : 54-66 months). The curve constructed with the reevaluation data show ed a sharp superiority of the Burch technique in terms of correction o f USI and associated genital prolapses. There was a progressive recurr ence rate that stabilized at 5 years, with values of 78.9% in group I and 40% in group II. Anterior colporrhaphy was ineffective for the cor rection of any of these parameters in group I. The data clearly show t he need to improve the presurgical diagnostic methods for the selectio n of patients that will benefit from treatment: detailed history of th e current disease and auxiliary tests such as Q-tip test, transvaginal ultrasound, and urodynamic study. Other factors were associated with ineffective treatment in both groups, such as hypoestrogenism (20/109) , excessive weight gain(19/109) and chronic intestinal constipation an d/or coughing present in 36 patients, with recurrence in 28 of them.