The use of prophylactic Stamey bladder neck suspension to prevent post-operative stress urinary incontinence in clinically continent women undergoing genitourinary prolapse repair

The present study was undertaken to evaluate the efficacy of Stamey bladder neck suspension in preventing post-perative stress urinary incontinence in clinically continent women undergoing surgery for genitourinary prolapse. Thirty clinically continent women with severe genitourinary prolapse were found to have a positive stress test with re-positioning of the prolapse. They all had significant urethrovesical junction hypermobility. In addition to the genitourinary prolapse repair, these patients underwent a prophylactic Stamey procedure to prevent the possible development of post-operative stress urinary incontinence. The mean duration of follow-up was 8+/-4.5 months (range, 3-19 months). Seven (23.30%) patients developed overt post-operative stress urinary incontinence that was confirmed urodynamically. Eleven (36.7%) other patients denied stress incontinence; however, post-operative urodynamics demonstrated sphincteric incontinence. Post-operative complications were uncommon and minor. In conclusion, continent patients with a positive stress test demonstrated on re-positioning of the prolapse during pre-operative urodynamic evaluation are considered to be at high risk of developing post-operative stress urinary incontinence. In these patients, an additional, effective anti-incontinence procedure should be considered during surgical correction of genitourinary prolapse. The Stamey procedure, although simple and safe, does not appear to be the optimal solution to this clinical problem.     

Treatment results using a mixed fiber mesh in patients with grade IV cystocele

PURPOSE: We determined the efficacy of a modification of the 4-corner bladder and bladder neck suspension procedure using mixed fiber mesh to correct grade IV cystocele. MATERIALS AND METHODS: We evaluated 15 women with a mean age of 67 years who had severe anterior vaginal wall prolapse, of whom 3 had concurrent enterorectocele. Previously 5 patients had undergone repair of anterior vaginal wall prolapse and 2 had undergone procedures for stress urinary incontinence. In 10 patients type II stress urinary incontinence was diagnosed with urethral hypermobility and abdominal leak point pressure greater than 90 cm. water. No patients with intrinsic sphincter deficiency were enrolled in the study. A mixed fiber mesh was positioned using a modification of the 4-corner bladder and bladder neck suspension technique. Patients with concurrent enterorectocele underwent simultaneous formal repair of the posterior descensus. RESULTS: All patients were available for postoperative pelvic examination at 3-month intervals. Mean followup was 23.4 months (range 18 to 39). Of the 15 women 13 were continent (dry) at followup. No recurrent cystocele was evident, except in 1 patient who presented with segmental posterior bladder prolapse. In 2 patients new onset enterorectocele developed 6 months after mesh implantation. CONCLUSIONS: Our study confirms that the addition of mesh to the classic 4-corner bladder base and neck suspension procedure effectively treats incontinence and cystocele. We recommend this method for cases in which traditional techniques have previously failed and when the quality of suspending tissue is poor or defective, as in connective tissue disease. However, the risk of worsening enterorectocele or its new onset must be considered.     

Videocystourethrography with a ring pessary in situ. A clinically useful preoperative investigation for continent women with urogenital prolapse?

The aim of the study was to evaluate the use of a vaginal pessary in the detection of genuine stress incontinence (GSI) in women with urogenital prolapse undergoing urodynamic investigation. Continent women with urogenital prolapse, with or without associated urinary symptoms, were studied. All underwent video-cystourethrography using a standarized protocol. None had evidence of incontinence on provocative testing in the upright position. A well-fitting vaginal ring pessary was inserted to reduce the prolapse and mimic a vaginal repair. The provocative tests were then repeated while the bladder was screened. Seventy women with a mean age 59.0 years (range 34–83) were recruited over a 21-month period: 15 women complained of prolapse alone and 55 had concurrent urinary symptoms; 19 women (27%) developed GSI only following the insertion of a vaginal pessary. The women who became incontinent were significantly older (mean age 63.9 years) than those who remained continent (mean age 56.8 years) (P<0.020). The use of a vaginal pessary increases the detection rate of GSI in continent women with urogenital prolapse undergoing videocystourethrography. These findings are important becasuse women with prolapse and coexisting incontinence should be offered a continence procedure rather than a simple vaginal repair.Editorial Comment: All patients with significant uterovaginal prolapse require preoperative evaluation to rule out the presence of potential stress incontinence. The simplest and best way to perform this preoperatively has yet to be determined, although several methods have been described. These include a cough stress test or cough urethral profile performed with a full bladder with the prolapse reduced with a Sims' speculum, a pessary or vaginal packing. A pad test with the prolapse reduced in a similar fashion has also been used clinically to identify patients at risk for postoperactive potential stress incontinence following correction of pelvic prolapse. The authors present their experience using a ring pessary to reduce the prolapse during videourodynamic evaluation of lower urinary tract function, finding this technique to be effective in identifying patients who leak only with the pessary in place, and therefore, require an incontinence procedure. The pickup rate for this cohort of patients is similar to previous studies using alternative methods of detection. Perhaps the only question yet to be answered is the percentage of patients with negative testing preoperatively, yet who develop urinary incontinence immediately following surgical correction of pelvic relaxation. Only this determination will truly assess the clinical utility of the preoperative methods used to identify potential stress incontinence.     

Four-corner bladder and urethral suspension for moderate cystocele

The classical approach to cystocele repair involves the approximation of lax pubocervical fascia through the anterior vaginal wall with narrowing of the bladder neck and proximal urethra by the Kelly-type plication. This procedure corrects the prolapse but when performed for the treatment of incontinence it has a high failure rate because the bladder neck and urethra are not placed into a high, supported, nonobstructed retropubic position. Furthermore, due to elevation of the bladder base without simultaneous elevation of the bladder neck and urethra, de novo stress urinary incontinence may occur. We developed a transvaginal needle suspension operation for the bladder and urethra that repairs anterior vaginal wall prolapse with excellent support of the bladder base and repositions the bladder neck in the high retropubic position, all during a simple and rapid operation that is tolerated well by the patient.     

Development of postoperative urinary stress incontinence in clinically continent patients undergoing prophylactic Kelly plication during genitourinary prolapse repair

The present study was undertaken to evaluate the efficacy of Kelly plication in preventing postoperative urinary stress incontinence in clinically continent patients undergoing surgery for genitourinary prolapse. Thirty clinically continent patients with grade-3 genitourinary prolapse were found to have a positive stress test with repositioning of the prolapse during preoperative urodynamic evaluation. In addition to the genitourinary prolapse repair, these patients underwent a Kelly plication as a preventive measure against possible development of postoperative urinary stress incontinence. Postoperative follow-up included a detailed urogynecologic questionnaire, pelvic examination, urine culture, Q-tip cotton swab test, and a full urodynamic evaluation. The mean duration of follow-up was 25.5 ± 14.1 months. Fifteen (50%) patients developed subjective and objective postoperative stress incontinence. Eleven (37%) patients developed objective postoperative stress incontinence (proven by urodynamic evaluation) with no subjective complaints of stress incontinence. Prophylactic Kelly plication as performed by the method described does not appear to be effective in preventing postoperative urinary stress incontinence in clinically continent patients who undergo surgery for genitourinary prolapse. Neurourol. Urodynam. 18:193–198, 1999. © 1999 Wiley-Liss, Inc.     

Urodynamic changes in voiding after anti-incontinence surgery: an insight into the mechanism of cure

Objectives. To measure the effect on voiding pressure and flow rate of three different operations for stress urinary incontinence.Methods. In a previous study of cure rates, 289 women with genuine stress incontinence and genital prolapse were prospectively allocated in a randomized manner to one of three procedures: the Burch retropubic urethropexy, anterior repair, or the modified Pereyra procedure. In the current derivative study, we retrospectively evaluated the urodynamic indicators of voiding dysfunction in the original subjects preoperatively and at the 1-year postoperative follow-up visit.Results. One hundred thirty-two charts were available for review. One year after surgery, pressure and flow during voiding were altered to more obstructive levels with the suspension procedures (Burch and modified Pereyra). The proportion of patients with obstructive and equivocal voiding patterns after the suspension procedures was significantly greater than after anterior repair.Conclusions. This post hoc comparison of randomized data shows a difference in postoperative voiding indexes between suspension procedures and anterior colporrhaphy. Successful bladder neck suspension depends on altering the pressure and flow during voiding to more obstructive levels. Suspension procedures alter the voiding pressure and flow toward obstruction to a greater extent than anterior repair.     

Repair of severe anterior vaginal wall prolapse (grade IV cystourethrocele)

The classical approach for the repair of severe anterior vaginal wall prolapse is the use of transvaginal colporrhaphy or, more recently, an abdominal paravaginal repair. Severe cystoceles develop from weaknesses of the levator sling and pubocervical fasciae resulting in 2 main anatomical changes: a central defect between the pubocervical fasciae, and a sliding herniation of the bladder and urethra (paravaginal defect). We developed a new transvaginal technique for the repair of large cystoceles (grade IV) extending outside of the introitus at rest, which includes repair of the central defect by anterior colporrhaphy, and repair of the paravaginal herniation of the bladder base and bladder neck by a needle suspension of these structures. We report our experience within a 5-year period in the treatment of 51 cases of severe bladder prolapse (grade IV cystoceles), 46 of which required this combined procedure regardless of preoperative stress urinary incontinence status. Five patients underwent anterior colporrhaphy as the only procedure, since they were continent and demonstrated a well supported bladder neck from a previous suspension operation. Other vaginal abnormalities should be repaired simultaneously to provide adequate pelvic floor support.     

Short-term outcome analysis of total pelvic reconstruction with mesh: the vaginal approach

PURPOSE: We describe our experience with transvaginal total pelvic reconstruction using a mesh with 4-point fixation for patients with genitourinary prolapse with or without stress urinary incontinence. MATERIALS AND METHODS: A total of 29 consecutive patients who underwent sacrospinous fixation using mesh material since March 1999 for genitourinary prolapse were analyzed retrospectively. In all patients defect specific repair was done, including hysterectomy (in 13). For isolated vault prolapse a rectangular mesh was interposed between the peritoneum and vaginal vault, with each corner anchored to the sacrospinous ligament using a suture-capturing device. For vault prolapse associated with anterior vaginal wall prolapse an "H" shaped, 1-piece sling was used to support both entities. Additionally, posterior and perineal repairs were done through separate incisions if needed. RESULTS: Of the 29 patients 19 (65.5%), 7 (26.92%) and 11 (39.29%) had associated symptoms of stress urinary incontinence, urgency and frequency, respectively, and 79.31% had associated anterior and 44.8% had associated posterior prolapse. Average operative time was 175.6 minutes, blood loss was 340 cc and hospital stay was 2.46 days. Early adverse events following the procedure were perineal pain, vaginal discharge and irritative voiding symptoms. At 6 month followup (mean 25.14 months) mild constipation and dyspareunia were encountered in a small subset of patients. Two patients (6.89%) have genital prolapse recurrence and none has reported erosion or nonhealing to date. CONCLUSIONS: Transvaginal technique of 4-point vaginal vault fixation using mesh is a safe and effective procedure at 2 years.     

Tension-free vaginal tape (TVT) for the treatment of occult stress urinary incontinence in women undergoing prolapse repair: a prospective study of 100 consecutive cases

AIMS: Clinically continent women with genitourinary prolapse and occult stress urinary incontinence (SUI) are considered to be at high risk of developing symptomatic SUI once the prolapse is repaired. We studied the efficacy and safety of tension-free vaginal tape (TVT) procedure in preventing postoperative SUI in these women. METHODS: One hundred consecutive women (mean age 66.7 +/- 9.9 years) with significant genitourinary prolapse and occult SUI were prospectively enrolled. Preoperatively, none of the women complained of SUI. However, all had urodynamically-confirmed occult SUI, revealed by repositioning of the prolapse. Surgical intervention was comprised of transvaginal prolapse repair and prophylactic TVT procedure. Main outcome end points included operative morbidity, postoperative SUI, persistent or de novo urge incontinence, and voiding dysfunction. RESULTS: The mean follow-up period was 27 months (range: 12-52 months). There was only one case of technique-related bladder perforation with no adverse outcome. Two other patients had postoperative urinary retention necessitating catheterization for more than 7 days, none of whom required any surgical intervention. Vaginal erosion of the tape was diagnosed in three patients, all of whom were successfully treated by excision of the eroded tape. Two (2%) patients developed urodynamically-confirmed SUI within 1 year postoperatively. However, postoperative urodynamics revealed asymptomatic sphincteric incontinence in 15 (15%) other patients. Thirteen (72%) of 18 patients with preoperative urge incontinence had postoperative persistent urge incontinence. De novo urge incontinence developed postoperatively in 8 (8%) patients. CONCLUSIONS: TVT procedure is effective and safe in patients with occult SUI undergoing prolapse repair. Long-term durability of this procedure is yet to be established.     

Anatomical correction of vaginal vault prolapse by uterosacral ligament fixation in women who also require a pubovaginal sling

PURPOSE: We describe the anatomical and functional outcome in patients who underwent vaginal vault fixation to the proximal uterosacral ligaments for the treatment of vault prolapse and who also required a concomitant pubovaginal sling for associated stress urinary incontinence as well as the repair of other sector defects. MATERIALS AND METHODS: We retrospectively analyzed the records of 33 patients who underwent such repairs between November 1998 and December 2001. Endopelvic fascial defects were described using the pelvic organ prolapse quantitative system (POPQ). Outcome measures included anatomical and functional assessment of pelvic floor defects and urinary incontinence. RESULTS: Preoperatively all patients complained of a vaginal bulge and stress urinary incontinence, while 17 of the 33 had urge incontinence, and 24 and 9 had POPQ stage III or IV and stage II prolapse, respectively. Mean followup was 28 months (range 6 to 43). There was significant improvement in all POPQ measurements (p <0.05). Most notably vaginal cuff support improved by a mean of 7 cm. Stages IIAp (rectocele) and IIC (cuff) prolapse developed in 4 and 2 failed cases, respectively. Stress urinary incontinence was cured in all 33 patients and urge incontinence was cured in 14 of 17, while in 27 vaginal prolapse symptoms resolved and most had improved defecation dysfunction. No patients had urinary obstructive symptoms. There were no ureteral, bladder or rectal complications but 1 patient required blood transfusion. CONCLUSIONS: Suspension of the vaginal cuff to the proximal uterosacral ligaments with site specific repair of other associated endopelvic fascial defects provides excellent anatomical and functional correction of vault prolapse. Furthermore, a concomitant pubovaginal sling is a compatible repair for associated stress urinary incontinence. It did not compromise vaginal repair and prolapse repair did not jeopardize the outcome of the sling.     

The vaginal strips sling operation. An alternative procedure for urinary incontinence

An alternative approach to the treatment of marked anterior vaginal prolapse and urinary incontinence is presented. Two strips of vaginal skin are used to elevate and suspend the bladder neck and the proximal third of the urethra. Of 82 patients who underwent the operation, 37 had had previous bladder neck repairs for urinary incontinence. A 95.1% success rate was achieved. The procedure is worth considering under certain circumstances.     

子宫脱垂患者行阴式子宫切除术联合阴道前后壁修补术后合并新发性压力性尿失禁的影响因素

目的探究子宫脱垂患者行阴式子宫切除术联合阴道前后壁修补术术后合并压力性尿失禁的相关影响因素,为子宫脱垂患者的个体化治疗提供临床参考依据。 方法选取2017年1月至2019年1月,天长市中医院住院行阴式子宫切除术联合阴道前后壁修补术的患者50例,术前患者已排除急性尿失禁、压力性尿失禁等情况,术后所有患者均顺利出院,术后随访2个月,根据患者的主观症状,体格检查结果、国际尿失禁咨询委员会尿失禁问卷简表以及尿动力学检查诊断并统计术后新发压力性尿失禁患者并对可能造成术后新发压力性尿失禁的因素进行统计分析。 结果（1）子宫脱垂患者行阴式子宫切除术联合阴道前后壁修补术治疗后新发压力性尿失禁患者15例,其中主观症状较为明显患者5例,主观症状及体格检查均无明显异常患者6例,完成问卷量表后方才明确诊断,经尿动力学检查方才明确诊断患者4例。（2）单因素分析发现糖尿病史、体质量指数、巨大胎儿分娩史、盆腔手术史是影响术后新发压力性尿失禁的相关影响因素。（3）以术后是否发生尿失禁作为因变量（0=未发生,1=发生）,将单因素分析中有统计学差异的4个影响因素纳入多因素Logistic回归分析,结果显示糖尿病病史、盆腔手术病史以及巨大胎儿分娩史是阴式子宫切除联合阴道前后壁修补术术后新发压力性尿失禁的独立危险因素。 结论对于合并巨大胎儿分娩史、盆腔手术史、糖尿病病史的子宫脱垂患者可于术前加强与患者的沟通交流,告知患者术后出现新发压力性尿失禁的风险,并在完善相关评估后建议患者同步性抗尿失禁手术以综合改善患者预后,提高患者术后生活质量。     

Pubovaginal sling and pelvic prolapse repair in women with occult stress urinary incontinence: effect on postoperative emptying and voiding symptoms

Objectives. To determine the perioperative morbidity of performing a concurrent pubovaginal sling with prolapse repair in women with occult (or potential) stress incontinence, particularly on voiding dysfunction and emptying.Methods. We reviewed the charts of 38 women with grade 3-4 pelvic prolapse and occult stress incontinence. All patients underwent video urodynamic testing with the prolapse unreduced and again with the prolapse reduced with a pessary or packing. The abdominal leak point pressure was determined. Appropriate surgical repair of all components of the prolapse was performed concurrently with pubovaginal sling placement. The outcomes were measured with respect to the time to spontaneous voiding, permanent urinary retention, development of stress incontinence or de novo urge incontinence, resolution of urge incontinence, and perioperative complications.Results. The mean age was 72 years, and the mean follow-up was 15 months (range 6 to 39). The mean time required before spontaneous voiding resumed without the need for catheterization was 11.8 days (range 2 to 46). No patient developed permanent urinary retention. Two (9.5%) of 21 women without preoperative urge incontinence developed de novo urge incontinence. However, existing urge incontinence resolved in 45%. One woman developed a suprapubic wound infection, which resolved with conservative management. Stress incontinence occurred in 2 women (7%) at 4 and 19 months postoperatively. Clinically significant prolapse (uterine) developed in 1 patient 2 years after surgery.Conclusions. Simultaneous pubovaginal sling placement for women with occult stress incontinence undergoing repair of a large pelvic prolapse is effective in preventing postoperative stress incontinence and has little negative effect on postoperative bladder emptying. It should be considered in all women with occult stress incontinence undergoing prolapse repair.     

Use of transvaginal endosonography in the evaluation of women with stress urinary incontinence.

Hypermobility of the bladder neck in response to increased intra-abdominal pressure is the anatomical cause of uncomplicated stress urinary incontinence in women. Transvaginal endosonography is a reliable, minimally invasive technique for demonstrating bladder neck hypermobility in patients with genuine stress urinary incontinence. Of 279 patients with genuine stress urinary incontinence evaluated during a 24-month period 271 (97%) had bladder neck hypermobility demonstrated by transvaginal endosonography. Resolution of stress urinary incontinence after surgical bladder neck suspension correlated with stabilization of bladder neck mobility on ultrasound examination. The technique is painless and easily performed in the office setting.     

Risk of recurrent stress incontinence in women undergoing the combined modified pereyra procedure and transvaginal sacrospinous ligament vault suspension

Objectives. To determine the risk of recurrent stress urinary incontinence in women undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension.Methods. A retrospective analysis of 62 patients who underwent the modified Pereyra procedure at Harbor-UCLA Medical Center between October 1, 1993 and July 10, 1999 for stress urinary incontinence was performed.Results. The study group consisted of 62 patients treated for stress incontinence; 34 (55%) of the 62 patients underwent the modified Pereyra procedure for stress incontinence, and 28 (45%) underwent the combined modified Pereyra procedure and sacrospinous ligament vault suspension for stress incontinence and coexistent uterine and/or vaginal vault prolapse. Patients undergoing the modified Pereyra procedure without vaginal vault suspension had higher subjective (91% versus 64%, P = 0.01) and objective (88% versus 61%, P = 0.02) cure rates of stress urinary incontinence compared with the patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension. The mean follow-up period for the patients undergoing the modified Pereyra procedure (23 ± 14.4 months) was similar to that of the patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension (26 ± 9.4 months) (P = 0.3). Compared with the objectively cured patients, patients with objective failure demonstrated postoperative bladder neck hypermobility and a higher rate of recurrent grade 2 or greater anterior vaginal prolapse. Eleven patients had postoperative detrusor instability, and 2 patients who underwent sacrospinous ligament vault suspension developed recurrent grade 3 apical vault prolapse.Conclusions. Patients undergoing the combined modified Pereyra procedure and sacrospinous ligament vault suspension have high rates of recurrent stress urinary incontinence.     

The role of anti-incontinence surgery in management of occult urinary stress incontinence

Combining anti-incontinence and pelvic organ prolapse surgery for patients with occult urinary stress incontinence is controversial. The concern is that some of these patients may remain continent after vaginal prolapse repair making the addition of anti-incontinence surgery unnecessary. However, this can be explained by the fact that the anterior vaginal repair has a curative effect on stress incontinence. Therefore, these patients are denied the more successful anti-incontinence surgery by treating their incontinence with vaginal repair. Once we are able to detect the true cases of occult urinary stress incontinence, all patients should be offered anti-incontinence surgery in combination of vaginal prolapse surgery.     

The ability of history and a negative cough stress test to detect occult stress incontinence in patients undergoing surgical repair of advanced pelvic organ prolapse

To determine if a negative preoperative reduction cough stress test is a viable method of detecting occult stress incontinence or urge incontinence in women undergoing surgical repair of advanced pelvic organ prolapse. A retrospective chart review was done on all patients who denied any urinary complaints and had repair of advanced pelvic organ prolapse, grade two or greater, without the addition of an anti-incontinence procedure. Additionally patients had a simple office filling study done at the time of initial examination that failed to show the sign of stress incontinence or detrusor instability. Any urinary dysfunction that developed postoperatively was noted. A total of 53 patients met the inclusion criteria. Of these patients, one patient (1.9%) developed genuine stress incontinence, and one patient complained of urgency (1.9%). Patients without urinary complaints and a negative office filling study, who were present for surgical correction of advanced pelvic organ prolapse, have a low incidence of developing occult stress incontinence. Further work-up would not be cost effective.     

Female sexual dysfunction following vaginal surgery: a review

PURPOSE: Depending on age it has been estimated that up to 40% of women have complaints of sexual problems, including decreased libido, vaginal dryness, pain with intercourse, decreased genital sensation and difficulty or inability to achieve orgasm. In this review we address the etiologies and incidence, evaluation and treatment of female sexual dysfunction following vaginal surgery for indications such as stress urinary incontinence and pelvic organ prolapse; anterior/posterior colporrhaphy, perineoplasty and vaginal vault prolapse. MATERIALS AND METHODS: Literature on the mechanisms by which vaginal surgery affects female sexual function are discussed along with related pathophysiology to potential causes. The anatomy, neurovascular supply of the clitoris and introitus, and intrapelvic nerve supply are discussed as related to vaginal surgery. Techniques to avoid neurovascular damage during pelvic floor surgery were corroborated by supporting literature. Literature regarding female sexual dysfunction following other procedures, such as vaginal hysterectomy, Martius flap interposition, and vesicovaginal and rectovaginal fistula repair were also discussed. RESULTS: Current literature does not support an association between vaginal length following vaginal surgery and sexual function. The proportion of women who are sexually active does not appear to be affected by vaginal surgery. Sling surgery for urinary incontinence does not appear to adversely affect overall sexual function, although individual parameters of sexual function scores may vary, eg a significant percent of women report pain during intercourse. Some patients experience improved overall sexual function due to complete relief from coital incontinence CONCLUSIONS: Symptomatic vaginal narrowing is rare even in women undergoing simultaneous posterior repair. Overall sexual satisfaction appears to be independent of therapy for urinary incontinence or prolapse. Data indicate that defect specific posterior colporrhaphy with the avoidance of levator ani plication may improve sexual function. The possible etiological factors for sexual dysfunction following vaginal surgery deserve further investigations.     

Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse?

This study aims to evaluate the changes of overactive bladder symptoms to anterior vaginal wall prolapse repair. Ninety-three consecutive women with symptomatic anterior vaginal wall prolapse ≥ stage II and coexistent overactive bladder symptoms were prospectively studied using a urinalysis, urodynamics, King’s Health Questionnaire (KHQ), Prolapse Quality of Life (P-QOL) questionnaire and pelvic organ prolapse quantification (POP-Q) system before and 1 year after surgery. All women underwent a standard fascial anterior repair. Postoperatively, urinary frequency, urgency and urge incontinence disappeared in 60, 70 and 82% of women respectively (p value < 0.001). The vaginal examination findings as well as the quality of life of the women assessed using KHQ and P-QOL significantly improved after surgery (p value < 0.001). This study has demonstrated that anterior vaginal repair does produce significant improvement in overactive bladder symptoms. A larger longer-term study is required to assess if these changes persist over time.