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INTRODUCTION: Clinically continent women with severe genitourinary prolapse and occult stress incontinence are considered to be at high risk of developing symptomatic stress incontinence once the prolapse is repaired. We studied the efficacy and safety of prophylactic anti-incontinence surgery in preventing postoperative stres incontinence in these women. METHODS: One hundred forty consecutive women with stage 3 or higher genitourinary prolapse and occult stres incontinence were enrolled between January 2005-January 2007. This was a retrospective study that compared women underwent prolapse surgery with prophylactic antiincontinence procedure (Group 1, n=105) and only prolapse surgery (Group 2, n=35). Preoperatively,none of the women complained of stress incontinence. Preoperative evaluation included history, physical examination and urodynamic assesment. However, all had urodynamically-confirmed occult stres incontinence, revealed by repositioning of the prolapse. The main outcome measures were postoperative stres incontinence,voiding dysfunction, de novo urgency and recurrence of prolapse. RESULTS: IPatient characteristics and preoperative urodynamic evaluation were similar in two groups. The mean duration of follow-up was 26.5 months and all patients underwent a repeat urodynamic evaluation at 3 months postoperatively.The rate of postoperative voiding disfunction, de novo urgency and recurrent prolapsus 15.2, 9.5, 2.9% in Group 1 and 5.7, 8.6, 5.7% in Group 2, respectively.There was no statistically difference among Group 1 and Group 2 (p>0,05). Nine (%8.6) patients in Group 1 and ten (%28.6) in Group 2 developed postoperative stress incontinence (p<0,05). DISCUSSION AND CONCLUSION: Prophylactic anti-incontinence procedure(TVT or Burch colposuspension) is effective in preventing postoperative urinary stress incontinence in clinically continent patients who undergo surgery for severe genitourinary prolapse

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