Urodynamic and roentgenologic changes following ventral levatorplasty

Abstract

Our first 23 patients treated by this method were followed up by urodynamic assessment and urethrocystovaginography 13 months after the operation. Urodynamic assessment was performed according to the criteria of the International Continence Society. There was no statistically significant difference in the resting urethral closure pressure (UCP), neither at maximum point nor at 30% or 70% of the urethral functional length (UFL). The postoperative reduction of UFL was statistically significant but did not exercise any significant influence on continence. The maximum bladder volume was not affected. For assessing the urethral stress profile we calculated the depression quotient which was significantly unfavourable at 30% of UFL but not affected at 70%. The lateral urethrocystovaginogram was interpreted according to Green. Most of the parameters were significantly improved. At the time of reexamination 70% of the patients were subjectively continent, whereas in 21.7% the incontinence remained unchanged and deteriorated in 8.6%. In our opinion, this modified anterior repair is not recommended as a method to encourage a wider range of indications for the vaginal repair of incontinence. Hence, this operation method should be performed only in case of an evident insufficiency of the vesicourethrovaginal septum.