[Long-term outcome of XXXX and prolapse surgery at the Heidelberg University Gynecologic Clinic 1980-1992].

@entity1 @entity322 @entity3142
OBJECTIVE: Long-term results after different types of operations for @entity3142 (minimum follow-up: 18 months) as well as multiple risk factors for the pelvic floor were analysed in a retrospective study. STUDY DESIGN: Between 1980 and 1992 1283 @entity1 underwent surgery because of @entity3142 at the University @entity1 's Hospital in Heidelberg. The data of 478 @entity1 , 430 of these after primary and 48 after recurrent surgery, were evaluated by questionnaires with regard to the long-term-results. RESULTS: 57% of @entity1 after primary surgical therapy and 37% after recurrent surgery were cured for longer than 5 years or since the operation. A cure or improvement of the @entity322 could be observed in 80% after primary and in 73% after recurrent surgery. Among the vaginal approaches for primary surgery the hysterectomy combined with colporrhaphy was most successful (60% cured or more than 5 years continent, 80.5% at least improved). The Burch colposuspension revealed even better results among the abdominal approaches (64% cured or longer than 5 years continent, 86% at least improved) compared to the Marshall-Marchetti-Krantz procedure with a cure rate of 33%. For therapy of the recurrent @entity322 the abdominal Burch colposuspension showed the best results with cure rates of 50% and cure or improvement in 75%. Therefore the abdominal approach seems to be superior to vaginal techniques such as sling operations (33% cure rate, 67% at least improved) or only re-colporrhaphy (27% cure rate, 78% at least improved). CONCLUSION: For primary @entity322 the hysterectomy with vaginal repair or the Burch colposuspension have proved to be most successful. For recurrent @entity322 the abdominal colposuspension (Burch procedure) seems to be superior to other approaches.
