Retropubic cystourethropexy: a review of two operative procedures with long-term follow-up.

The purpose of this report is to present a personal experience, with an up to 16-year follow-up, in the management of stress urinary incontinence using a retropubic cystourethropexy. An attempt is made to prove that, in addition to the standard Kelly anterior colporrhaphy, a transvaginal retropubic cystourethropexy helps to improve long-term results. Also, the results of transvaginal retropubic cystourethropexy (modified Pereyra procedure) and abdominal retropubic cystourethropexy (modified Marshall-Marchetti-Krantz procedure) are reviewed. Two hundred fifty-two patients received a modified Pereyra procedure and 490 patients underwent a modified Marshall-Marchetti-Krantz procedure in a 17-year period. The final corrected results of both of these procedures indicate that the percentage of patients clinically cured are almost identical (93%). Thus, for the treatment of genuine stress urinary incontinence, either the modified Pereyra procedure plus anterior colporrhaphy or the Marshall-Marchetti-Krantz procedure can be used with almost identical results. The route of the procedure performed, either abdominally or vaginally, is often determined by associated findings.