SUCCESS AND QUALITY-CONTROL OF PROCEDENTIA AND URINARY STRESS-INCONTINENCE SURGERY - COMPARATIVE USE OF URODYNAMICS AND TRANSRECTAL ENDOSONOGRAPHY

We evaluated the significance of urodynamic parameters versus transrectal ultrasound with regard to postoperative outcome-control after operation for procedentia and urinary stress incontinence. We studied 30 continent women and 84 women with purely stress induced urinary incontinence. All had a pre- and postoperative urodynamic testing including urethral profilometry and cystometry, paralleled by a transrectal ultrasound examination. From the urodynamic parameters only the transmission ratio is suitable to judge the surgical outcome, although it is less correlative to the patient's complaints (p=0,033) than the bladder neck mobility (p<0,0001, Tab.5). Within the rather short time of follow-up, each of the operation-techniques was able to improve the bladder neck mobility significantly. Nevertheless, anterior colporrhaphia is not suitable for incontinence-surgery (Fig. 2/Tab. 5). Concerning operative results, transrectal endosonography was found to be an adequate or even superior method as compared to urodynamic studies, because it can likewise demonstrate the function of the bladder neck, but furthermore can show the morphologic aspects of bladder, urethra and pelvic floor. As a result, for the first time, this minimal invasive method offers quality control for the individual surgeon as well as for long-term follow-up studies after operation for procedentia and stress induced urinary incontinence without using much time or causing great discomfort to the patient.