Four-corner colposuspension: clinical and functional results

Area of Science:

• Urogynecology
• Pelvic reconstructive surgery

Background:

• Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common conditions affecting women.
• Surgical interventions aim to restore pelvic anatomy and function.

Purpose of the Study:

• To evaluate the long-term functional and objective outcomes of four-corner colposuspension for POP and SUI.
• To identify ideal candidates for this surgical procedure.

Main Methods:

• Retrospective study of 37 women (aged 42-74) undergoing four-corner colposuspension.
• Procedures were combined with posterior colpoperineoplasty or vaginal wall sling in select cases.
• Preoperative and follow-up assessments included clinical exams, symptom questionnaires, ultrasound, and urodynamic testing.

Main Results:

• Successful urethrocele correction in all patients.
• No recurrence in 19 patients with mild-to-moderate cystocele (Grade I-II).
• Recurrence of prolapse in 12/18 patients with severe cystocele (Grade III).
• 85% success rate in resolving stress urinary incontinence (23/27 patients).
• No major complications reported.

Conclusions:

• Four-corner colposuspension is a safe and effective procedure for moderate cystocele and stress incontinence.
• Patients with moderate cystocele and no uterine prolapse are ideal candidates.
• Outcomes are less favorable in cases of severe prolapse with significant cystocele.