Barnett-Macku Modification of Anterior Colporrhaphy
in Prevention and Treatment of Stress Urinary
Incontinence in Women with Cystocele
Chmel R., Vlk R., Rob L., Horčička L.
Gynekologicko-porodnická klinika UK 2. LF a FN v Motole, Praha, přednosta prof. MUDr. J. Hořejší, DrSc. |
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Summary:
Objective: The evaluation of the success rate in prevention and treatment of stress incontinence
in 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 Teaching
Hospital Motol, Prague.
Methods: Comparative questionnaire study of 41 patients operated between 1998 and 2000 for
cystocele by Barnett-Macku modification of anterior colporrhaphy and the control group of 75
patients operated by Stoeckel modification.
Preoperative examination included history, gynecological examination and evaluation of urinary
continence. Body mass index, obesity, age, parity and hormonal status were recorded in the time
of surgery. Stress and urge incontinence, lower urinary tract infections, hormonal therapy, recurrency
of the prolapse and quality of life improvement were evaluated in follow-up. Yes-no logistic
regression test and
2 test were used for the statistical analysis.
Results: In the group of patients operated for cystocele by Barnett-Macku modification of anterior
colporrhaphy statistically significant higher success rate in the prevention and treatment of concomitant
stress urinary incontinence was demonstrated. Prophylactic effect of the procedure was also
documented 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 contribution
into the register of reconstructive vaginal operations primary for the treatment of cystocele
and secondary for the prevention of latent and treatment of concomitant stress incontinence.
Key words:
anterior colporrhaphy, vaginal hysterectomy, cystocele, uterine prolapse, stress urinary
incontinence
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