Outcome of sphincteroplasty combined with surgery for urinary incontinenceand pelvic organ prolapse

PURPOSE: This is the first reported prospective study comparing outcome and cost in patients undergoing sphincteroplasty for anal incontinence vs. sph incteroplasty performed in combination with one or more procedures for urin ary incontinence and/or pelvic organ prolapse. METHODS: We analyzed 44 pati ents with fecal incontinence who underwent anal sphincter repair alone (20 patients) or in combination with procedures for urinary incontinence or pel vic organ prolapse (24 patients). Information regarding risk factors for fe cal incontinence, the degree of incontinence, and the extent that incontine nce limited social, physical, and sexual activity was prospectively obtaine d from questionnaires. Clinic chart reviews and follow-up telephone intervi ews provided additional data. A cohort of case-matched patients who underwe nt only urogynecologic procedures was compared retrospectively for operativ e time, hospital cost, length of stay, and postoperative complications. RES ULTS: There were no major complications in any group. The functional outcom es, physical, social, and sexual activity were similar in all three groups. Twenty-two of 24 patients who underwent the combined procedures were glad that they had both procedures concomitantly. CONCLUSION: Combination pelvic floor surgery provides good outcomes and is cost effective. This approach should be offered to women with concurrent problems of fecal and urinary in continence and/or pelvic organ prolapse.