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  • Title: Failure to predict and attempts to explain urinary stress incontinence following vaginal repair in continent women by using a modified lateral urethrocystography.
    Author: Borstad E, Skrede M, Rud T.
    Journal: Acta Obstet Gynecol Scand; 1991; 70(6):501-6. PubMed ID: 1842676.
    Abstract:
    Of continent women undergoing the Manchester procedure for genito-urinary prolapse, about 25% develop urinary stress-incontinence. In order to study whether this is due to pre-existing anatomical factors or to the surgical procedure itself, a prospective study was set up. Fifty-eight continent women operated on for genito-urinary prolapse, underwent urethrocystography prior to and 3 months following surgery. Sixteen of the 58 (28%) developed stress-incontinence following the operation. Radiological parameters preoperatively were of little help in distinguishing the patients developing incontinence from those remaining continent. The stress-incontinence following a Manchester procedure for genital prolapse seems to depend on two surgical factors: an insufficient elevation of the bladder-neck and a radical reduction of the cystocele. A parameter combining the two factors: the percentage reduction of the cystocele minus the percentage elevation of the bladder-neck, was significantly lower in women remaining continent than in those who developed stress-incontinence.
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