ARE THERE FEWER VOIDING DIFFICULTIES IF A LATERAL REPAIR IS PERFORMEDIN ADDITION TO AN ABDOMINAL COLPOSUSPENSION - REPORT OF 4 CASES - BACKGROUND

Background: Abdominal colposuspension is known to cure stress urinary incontinence very successfully. In some cases voiding difficulties may develop. Instead of immobile bladder neck fixation the lateral repair is used to restore normal anatomy with correction of paravaginal loss of support. It has been reported that the lateral repair procedure ha s lower success rates concerning stress urinary incontinence, but ther e are no voiding difficulties. It is as yet not clear whether colposus pension in combination with lateral repair for stress urinary incontin ence and paravaginal defects preserves the good results of colposuspen sion procedures and leads to a lower incidence of postoperative voidin g difficulties. Patients and Methods: To prove this hypothesis four co nsecutive patients who underwent abdominal colposuspension and lateral repair are compared concerning postoperative micturition to four pati ents who had an abdominal colposuspension alone. Results: None of the four patients which had abdominal colposuspension and lateral repair d eveloped either urinary retention or voiding difficulties. The suprapu bic catheter was removed on the first and second day after beginning o f micturition training. One of the patients who underwent colposuspens ion alone had urinary retention. The other three women showed no voidi ng difficulties but in three cases their postvoiding volume after the first spontaneous micturition was more than 100 mi. In these women the suprapubic catheter was removed on the second, third and fifth day of micturition training. Discussion: These cases support the hypothesis that the additionally performed lateral repair procedure reduce postop erative voiding difficulties that may develop after an abdominal colpo suspension for stress urinary incontinence.