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Colpocleisis and tension-free vaginal tape sling for severe uterine and vaginal prolapse and stress urinary incontinence under local anesthesia.
J Am Assoc Gynecol Laparosc. 2003 May; 10(2):276-80.JA

Abstract

STUDY OBJECTIVE

To describe the technique, complications, and outcomes of vaginal repair of concomitant advanced uterine and vaginal prolapse and stress urinary incontinence using colpocleisis and tension-free vaginal tape (TVT) and pubovaginal sling under intravenous sedation and local anesthesia in elderly and/or medically compromised patients.

DESIGN

Retrospective analysis (Canadian Task Force classification III).

SETTING

Large tertiary care hospital with university affiliation.

PATIENTS

Thirty consecutive women.

INTERVENTION

Colpocleisis and TVT-pubovaginal sling.

MEASUREMENTS AND MAIN RESULTS

Data were obtained by retrospective chart review of office and surgical records and follow-up physical examinations. All 30 patients had the procedure completed without general anesthesia. Mean estimated blood loss was 56 ml (range 10-150 ml), mean operating time 97.3 minutes (range 65-135 min), and mean hospital stay 1.62 days (range 1-12 days). No intraoperative complications occurred, although one woman experienced a postoperative myocardial infarction. Average follow-up was 19.1 months. Three women required reoperation for minor prolapse (2 posterior repairs, 1 anteroposterior repair) and 94% were cured of stress incontinence.

CONCLUSION

Preliminary data suggest that surgical correction of concomitant severe pelvic organ relaxation and stress urinary incontinence using a proved procedure (pubovaginal sling) coupled with colpocliesis can be performed rapidly and safely with local anesthesia and mild sedation, thus limiting the potential risks of general anesthesia and more invasive surgical procedures.

Authors+Show Affiliations

Division of Urogynecology, Department of Obstetrics and Gynecology, Northside Hospital, Atlanta, GA, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12732784

Citation

Moore, Robert D., and John R. Miklos. "Colpocleisis and Tension-free Vaginal Tape Sling for Severe Uterine and Vaginal Prolapse and Stress Urinary Incontinence Under Local Anesthesia." The Journal of the American Association of Gynecologic Laparoscopists, vol. 10, no. 2, 2003, pp. 276-80.
Moore RD, Miklos JR. Colpocleisis and tension-free vaginal tape sling for severe uterine and vaginal prolapse and stress urinary incontinence under local anesthesia. J Am Assoc Gynecol Laparosc. 2003;10(2):276-80.
Moore, R. D., & Miklos, J. R. (2003). Colpocleisis and tension-free vaginal tape sling for severe uterine and vaginal prolapse and stress urinary incontinence under local anesthesia. The Journal of the American Association of Gynecologic Laparoscopists, 10(2), 276-80.
Moore RD, Miklos JR. Colpocleisis and Tension-free Vaginal Tape Sling for Severe Uterine and Vaginal Prolapse and Stress Urinary Incontinence Under Local Anesthesia. J Am Assoc Gynecol Laparosc. 2003;10(2):276-80. PubMed PMID: 12732784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colpocleisis and tension-free vaginal tape sling for severe uterine and vaginal prolapse and stress urinary incontinence under local anesthesia. AU - Moore,Robert D, AU - Miklos,John R, PY - 2003/5/7/pubmed PY - 2003/9/27/medline PY - 2003/5/7/entrez SP - 276 EP - 80 JF - The Journal of the American Association of Gynecologic Laparoscopists JO - J Am Assoc Gynecol Laparosc VL - 10 IS - 2 N2 - STUDY OBJECTIVE: To describe the technique, complications, and outcomes of vaginal repair of concomitant advanced uterine and vaginal prolapse and stress urinary incontinence using colpocleisis and tension-free vaginal tape (TVT) and pubovaginal sling under intravenous sedation and local anesthesia in elderly and/or medically compromised patients. DESIGN: Retrospective analysis (Canadian Task Force classification III). SETTING: Large tertiary care hospital with university affiliation. PATIENTS: Thirty consecutive women. INTERVENTION: Colpocleisis and TVT-pubovaginal sling. MEASUREMENTS AND MAIN RESULTS: Data were obtained by retrospective chart review of office and surgical records and follow-up physical examinations. All 30 patients had the procedure completed without general anesthesia. Mean estimated blood loss was 56 ml (range 10-150 ml), mean operating time 97.3 minutes (range 65-135 min), and mean hospital stay 1.62 days (range 1-12 days). No intraoperative complications occurred, although one woman experienced a postoperative myocardial infarction. Average follow-up was 19.1 months. Three women required reoperation for minor prolapse (2 posterior repairs, 1 anteroposterior repair) and 94% were cured of stress incontinence. CONCLUSION: Preliminary data suggest that surgical correction of concomitant severe pelvic organ relaxation and stress urinary incontinence using a proved procedure (pubovaginal sling) coupled with colpocliesis can be performed rapidly and safely with local anesthesia and mild sedation, thus limiting the potential risks of general anesthesia and more invasive surgical procedures. SN - 1074-3804 UR - https://www.unboundmedicine.com/medline/citation/12732784/Colpocleisis_and_tension_free_vaginal_tape_sling_for_severe_uterine_and_vaginal_prolapse_and_stress_urinary_incontinence_under_local_anesthesia_ L2 - http://www.diseaseinfosearch.org/result/3797 DB - PRIME DP - Unbound Medicine ER -