Four vertex technique for correcting urethral prolapse: technique description and cohort study

Area of Science:

• Urology
• Gynecology

Background:

• Urethral prolapse is a condition affecting women, often presenting with symptoms like bleeding or a bulging sensation.
• Surgical intervention is a common treatment modality for urethral prolapse.

Purpose of the Study:

• To describe the procedure and evaluate the effectiveness of the four-vertex technique for correcting urethral prolapse.
• To analyze patient characteristics and outcomes following the four-vertex technique.

Main Methods:

• A retrospective case series of 17 female patients who underwent surgery for urethral prolapse using the four-vertex technique.
• Analysis of variables including age, BMI, medical history, and treatment outcomes, with a distinction between patients with and without pelvic heaviness symptoms.

Main Results:

• The four-vertex technique resolved symptoms in 82.35% of postmenopausal women (mean age 70.41 years).
• Common presenting symptoms were urethrorrhagia and a bulging sensation. Post-surgery, 11.76% experienced dysuria and 5.88% had urinary urgency.
• Pre-surgical urinary incontinence resolved in 90% of affected patients; 17.46% developed subsequent pelvic organ prolapse.

Conclusions:

• The four-vertex technique is effective for treating urethral prolapse, with most patients becoming asymptomatic.
• Potential post-operative complications include dysuria, urgency, and pelvic organ prolapse, necessitating further research and patient counseling.
• The study highlights associations between patient factors and outcomes, offering insights for managing urethral prolapse.