Vaginal hysterectomy allied with Kelly-Kennedy surgery and perineal repair for the treatment of patients with a prolapsed uterus and urinary stress incontinence

Clin Exp Obstet Gynecol. 2002;29(1):27-30.

Abstract

Purpose: To evaluate patients with uterine prolapse, before and after surgical treatment, using urodynamic and bladder neck ultrasound.

Material and methods: 33 postmenopausal patients with uterine prolapse were submitted to vaginal hysterectomy (Mayo-Ward technique) allied with Kelly-Kennedy surgery and perineal repair. The women were divided into three groups depending on the degree of prolapse. A urodynamic examination was performed before, after 30 days and in the third month after the operation. A bladder neck ultrasound was performed before and in the third month after the operation.

Results: In 23 women who lost urine preoperatively, 14 continued to show objective loss 90 days after the surgery. Ultrasound identified a significant elevation in the bladder neck during rest in groups I and II, but not in group III. There was a significant reduction in its mobility in all three groups.

Conclusion: Kelly-Kennedy surgery does not have any indication, even in patients with urinary stress incontinence and a prolapsed uterus who are submitted to vaginal hysterectomy.

MeSH terms

  • Female
  • Gynecologic Surgical Procedures*
  • Humans
  • Hysterectomy, Vaginal*
  • Middle Aged
  • Perineum / surgery*
  • Urinary Incontinence, Stress / complications
  • Urinary Incontinence, Stress / physiopathology
  • Urinary Incontinence, Stress / surgery*
  • Urodynamics
  • Uterine Prolapse / complications
  • Uterine Prolapse / surgery*