Barnett-Macku Modification of Anterior Colporrhaphyin Prevention and Treatment of Stress UrinaryIncontinence in Women with Cystocele

Overview

Objective:
The evaluation of the success rate in prevention and treatment of stress incontinencein patients with cystocele operated by Barnett-Macku modification of anterior colporrhaphy.Design: Retrospective clinical trial.Setting: Obstetrics and Gynecology Department, Charles University 2nd Medical Faculty and TeachingHospital Motol, Prague.Methods: Comparative questionnaire study of 41 patients operated between 1998 and 2000 forcystocele by Barnett-Macku modification of anterior colporrhaphy and the control group of 75patients operated by Stoeckel modification.Preoperative examination included history, gynecological examination and evaluation of urinarycontinence. Body mass index, obesity, age, parity and hormonal status were recorded in the timeof surgery. Stress and urge incontinence, lower urinary tract infections, hormonal therapy, recurrencyof the prolapse and quality of life improvement were evaluated in follow-up. Yes-no logisticregression test and
2 test were used for the statistical analysis.Results: In the group of patients operated for cystocele by Barnett-Macku modification of anteriorcolporrhaphy statistically significant higher success rate in the prevention and treatment of concomitantstress urinary incontinence was demonstrated. Prophylactic effect of the procedure was alsodocumented by the fact that no one stress incontinent woman after surgery appeared in this group.Conclusion: Barnett-Macku modification of anterior colporrhaphy is reliable and successful contributioninto the register of reconstructive vaginal operations primary for the treatment of cystoceleand secondary for the prevention of latent and treatment of concomitant stress incontinence.

Key words:
anterior colporrhaphy, vaginal hysterectomy, cystocele, uterine prolapse, stress urinaryincontinence