A vaginal approach to the treatment of genital prolapse.

The surgical treatment of 409 patients with genital prolapse is described. The procedure, which invariably included hysterectomy, concentrated upon one of the major complaints of these patients, i.e., their stress-incontinence. Special care was taken not to shorten the urethral length. Two hundred of these patients were available for a relatively long follow-up period ranging from 7 to 13 yr. Within the first post-operative year, stress-incontinence appeared to have been cured in 90% of the patients. The long-term results show that the percentage of continent women has diminished to 81, which is an important finding probably not attributable to the surgical technique. In the long term, the second most frequent complaint of low back pain has recurred in 29% of our patients.