Even after a failed synthetic mid urethral sling, autologous pubovaginal sling is effective and cured stress urinary incontinence in 69.7% of cases.

Objectives The support of the uterine cervix assessed in the clinic with Valsalva or cough and operating room (OR) with traction often differs. The objective of this study is to test the null hypothesis that the difference between preoperative and intraoperative values of POP-Q (Pelvic Organ Prolapse Quantification) point C is not related to prolapse size, and to determine if other factors exist that predict this difference. Methods This is a retrospective review of women who had a vaginal hysterectomy in the FPMRS (Female Pelvic Medicine and Reconstructive Surgery) division between 2005 and 2011 and had preoperative and intraoperative POP-Q point C recorded. A difference of 5 cm was established by a panel of urogynecologists as clinically significant. Student t-tests and chi-squared analyses were used and a logistic regression performed. Results There were 206 subjects included. The mean difference in point C between the two clinical settings was 3.5 cm. A difference of ≥5 cm was present in 33%. The mean difference in point C was larger for women with lesser stages of prolapse (stage 1: 5.8 cm, stage 2: 3.0 cm, stage 3/4: 1.4 cm, p<.001). A difference of ≥5 cm in point C was more often present in women with lesser stages of prolapse–70.3% of women with stage 1, 9.3% for stage 2 and 8.5% for stage 3 (p<0.001). Conclusions We reject our null hypothesis. A difference of ≥5 cm between POP-Q point C in the clinic and the operating room occurred more frequently in women with lesser stages of prolapse.