[The Barnett-Macku method of anterior colporrhaphy in the prevention and treatment of urinary stress incontinence in women with cystocele].

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 chi 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.