Results of surgical treatment of urethral prolapse in women

Abstract

The study objective is to analyze the results of surgical treatment of urethral prolapse in women and to determine the optimal surgical tactics.Materials and methods. The authors conducted a retrospective analysis of case histories of 17 patients aged from 52 to 78 years who were treatedfrom 2003 to 2018 at the clinical bases of the Department of Urology of the North-Western State Medical University n. a. I.I. Mechnikov.Results. The urethral prolapse of the segmentalform was detected without complication in 4 women, and paraurethral cysts and urethral polyps accompanied in 3patients. In 13 others, circular forms complicated by urethrorrhagia and necrosis were detected. It is established that conservative therapy is often ineffective, with a circularform of urethral prolapse. At the same time, surgical tactics consist in strengthening the urethra (urethropexy) using tension free vaginal tape and obturator, mucosal plication or resection of a section of tissue leaving the urethra gives a favorable prognosis, and timely surgery helps prevent prolapse complications such as urinary retention or anemia due to chronic bleeding.Conclusion. Timely surgical treatment allows to quickly eliminate prolapse, which is accompanied by a favorable prognosis. This condition rarely leads to serious and life-threatening complications. Conservative methods of treatment are ineffective, especially with circular prolapse of the urethra, but such therapy is possible with a segmentalform, and also as a preparatory stage for surgical intervention; prevention of urethral prolapse is effective in the timely treatment of urinary tract infections, diseases of the gastrointestinal tract, weight control, exclusion of excessive physical exertion, active lifestyle.

Keywords

• urethral prolapse
• urethral caruncle
• surgical treatment
• urethropexy