Impact of rectal prolapse and rectocele repair surgery on the results of TVT

Objectives: The comorbidity between rectal repair surgery and stress urinary incontinence (SUI) repair by TVT(R) (simplified suburethral sling procedure) is a poorly defined entity. The objective of this study was to evaluate the influence of this combination on the quality of postoperative voiding and urinary continence. Methods: Retrospective analysis of 12 patients (group 1) simultaneously treated by TVT(R) and rectocele repair by anterior rectal mucosectomy (Sullivan: 6 cases) or rectal prolapse repair (open rectal fixation: 6 cases). They were compared to a group of 12 randomly selected patients (group 2) treated by TVT(R) alone during the same period. Results: A significant post-voiding residual urine volume was observed in 4 women of group 1 versus only one woman of group 2. All patients subsequently and spontaneously resumed satisfactory voiding except for one woman of group 1, in whom self-catheterization had to be maintained. After a mean follow-up of 18 months for group 1 and 17 months for group 2, only one woman, in group 2, was still incontinent. Conclusion: Rectal repair surgery, combined with TVT(R), increases the risk of transient postoperative urinary retention. This surgical combination does not appear to modify the medium-term result of the urological procedure.