Outcomes of the association of asymptomatic cystocele repair in patients undergoing mid-urethral sling surgery for the correction of stress incontinence

Abstract
Background
Comparison between the clinical outcomes of mid-urethral sling procedure for stress incontinence with and without repair of asymptomatic stage II cystocele is made.

Methods
This is a prospective randomized study of 72 female patients with stress urinary incontinence and asymptomatic stage II cystocele. The patients were divided into two groups: group 1 treated with trans-obturator tape only and group 2 with repair of cystocele by anterior colporrhaphy in the same session. We compared between both groups in cure rate and voiding function after 1 year.

Results
The cure rate of group 1 was 66.7%, while for group 2 it was 90% after 12 months (p < 0.05). Six patients (17%) with asymptomatic stage II cystocele in group 1 became symptomatic or developed higher stage after 12 months that required surgical repair. The incidence of postoperative irritative urinary symptoms was also significantly higher in group 1. There were no significant differences in the change in maximum flow rate or postvoiding residual urine between the two groups postoperatively.

Conclusion
Concomitant repair of stage II asymptomatic cystocele with mid-urethral sling improves the cure rate of stress urinary insentience and reduces the incidence of irritative urinary symptoms.