e-ISSN 1973-4913
Volume : 41 Issue : 1 Year : 2022
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pelviperineology. 2021; 40(1): 32-38 | DOI: 10.34057/PPj.2021.40.01.005

Effects of the apical suspension of the upper vagina by cervicosacropexy or vaginosacropexy on stress and mixed urinary incontinence

WOLFRAM JÄGER1, ANDREAS BRAKAT1, SEBASTIAN LUDWIG1, PETER MALLMANN1
1Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, University Hospital Cologne and Medical Faculty, Cologne, Germany

Objective: :Cervicosacropexy (CESA) and vaginosacropexy (VASA) are standardized surgical procedures to elevate and tighten the apical end of the vagina. A combination of CESA or VASA, and a transobturator tape was reported to cure urgency urinary incontinence (UUI). However, the efficacy of CESA or VASA in curing stress urinary incontinence (SUI) has not been investigated.
Materials and Methods: :Patients with SUI were asked to specify the situation when they urinated involuntarily. All of these patients were never operated on the genital tract before. In all the patients, the uterosacral ligaments were replaced by polyvinylidenefluoride tapes of identical length. The surgical outcomes in terms of vaginal anatomy and urinary incontinence were established several weeks after surgery. SUI was subdivided into SUI 1 (urinary loss while sneezing and coughing) and SUI 2 (urinary loss while performing other activities).
Results: :In addition to the anatomical effect, the apical fixation of the upper vaginal wall by CESA and VASA led to continence in 57% of the patients. The continence (cure) rate was higher in patients with SUI 1 (73%) than that in patients with SUI 2 (51%). The cure rate decreased with increase in the age of the patient at surgery. Of the 161 patients, 144 (89.4%) patients with SUI 2 were clinically having UUI. CESA and VASA led to continence in 39.1% and 29.3% of these patients, respectively.
Conclusion: :CESA and VASA can establish urinary continence in 29% to 48% of patients with stress and UUI. Continence rates decreased with patients’ age.


Cite This Article

JÄGER W, BRAKAT A, LUDWIG S, MALLMANN P. Effects of the apical suspension of the upper vagina by cervicosacropexy or vaginosacropexy on stress and mixed urinary incontinence. 2021; 40(1): 32-38

Corresponding Author: JÄGER W.

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