[Genital prolapse and urinary incontinence. A clinical assessment of patients with prolapse with particular emphasis on surgical methods and their long-term effects].

A review based on a follow up of 215 patients who had been treated operatively for genital prolapse and urinary incontinence after observation for 5-10 year is presented. The operation regime was predominantly conventional and the various vaginal methods involved 182 patients (80%). The Kelly-Kennedy plastic operation (K-K-pl) was employed for stress incontinence and slighter cases of prolapse. In more severe degrees of both of these conditions, K-K-pl was combined with the Manchester operation. The operative method of election in this department for marked cases of utero-vaginal descent was the Manchester operation supplemented by colpo-perineal plastic. The most advanced cases of prolapse were treated either with the Moschowitz operation or colpocleisis. This investigation revealed that the late results of the individual methods at primary operative treatment of both prolapse and incontinence showed the same high results of treatment with satisfactory results in 75-100%. On the other hand, the results of secondary operation showed great variation, depending upon the method, with satisfactory results from 25-85%.