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The modified Pereyra (Raz) procedure for genuine stress incontinence—A useful option in the elderly or frail patient?

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Abstract

This is a prospective uncontrolled observational study to assess the modified Pereyra procedure for the treatment of genuine stress incontinence in women over the age of 65. Fifty women with proven genuine stress incontinence had pre- and postoperative clinical and urodynamic assessment with a follow-up for up to 2 years. At 2 months there was a subjective cure rate of 64% and an objective cure rate of 46%. The 2-year objective cure rate was 46%. The operation produced no voiding difficulties. Results were poorer in those who had had previous surgery, had preoperative detrusor instability, or were nulliparous. We conclude that the modified Pereyra may be recommended for parous patients without previous bladder neck surgery. Other patients may be more appropriately dealt with by a colposuspension, sling or periurethral collagen.

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Authors and Affiliations

  1. St George's Hospital, SW17, London, UK

    S. L. Stanton (Consultant Gynaecologist)

  2. Department of Obstetrics and Gynecology, Royal Surrey County Hospital, Guildford, Surrey

    S. F. Reynolds

  3. Urogynaecology Unit, Department of Obstetrics and Gynecology, University College Hospital, London, UK

    S. M. Creighton

Authors
  1. S. L. Stanton
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  2. S. F. Reynolds
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  3. S. M. Creighton
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Additional information

Editorial Comment: The elderly patient with incontinence constitutes a problematic group for the surgeon. Vaginal stenosis, atrophy and tissue frailty, together with neuromuscular and neurologic alterations, are a property of advanced age. The efficacy of abdominal colpourethrocystopexy in such cases is incontestable, but is greatly limited by these problems. It should be noted that although the cure rate is around 50% 2 months after surgery, the same is maintained objectively 2 years later, which should not invalidate this procedure when the suprapubic route cannot be used. The sling procedures are not exempt from complications, mainly chronic retention requiring intermittent catheterization, which is also problematic in this age group.

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Stanton, S.L., Reynolds, S.F. & Creighton, S.M. The modified Pereyra (Raz) procedure for genuine stress incontinence—A useful option in the elderly or frail patient?. Int Urogynecol J 6, 22–25 (1995). https://doi.org/10.1007/BF01961844

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  • DOI: https://doi.org/10.1007/BF01961844

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