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Combined genital prolapse repair reinforced with a polypropylene mesh and tension-free vaginal tape in women with genital prolapse and stress urinary incontinence: a retrospective case-control study with short-term follow-up.
Acta Obstet Gynecol Scand. 2004 Oct; 83(10):950-4.AO

Abstract

BACKGROUND

To evaluate the tension-free vaginal tape (TVT) in both stress urinary incontinence (SUI) and occult SUI as an associated procedure at the time of tension-free polypropylene mesh repair for the treatment of genitourinary prolapse.

METHODS

Forty-eight consecutive women undergoing surgery for genital prolapse and concurrent SUI from November 1999 to September 2002. Preoperatively, SUI was symptomatic in 29 women and occult in 19, with a positive stress test during repositioning of the prolapse. All patients had urethral hypermobility and none had intrinsic sphincter deficiency. The cystocele repair was performed in all patients according to the technique of tension-free polypropylene mesh. Twenty-six women had an associated TVT and 22 had no associated procedure for SUI (control group). The main outcome measures were postoperative SUI, voiding dysfunction, and recurrence of prolapse.

RESULTS

The median follow-up was 20 +/- 10.1 months (range 7-41). Patient characteristics and preoperative urodynamic evaluation were similar in the two groups. In patients with preoperative SUI, postoperative SUI occurred in 1/15 of the TVT group (6.7%) vs. 5/14 (35.7%) in the control group (p < 0.05), and voiding dysfunction occurred in 2/15 patients of the TVT group (13.3%) vs. 0/14 in the control group (p > 0.05). In patients with preoperative occult SUI, postoperative SUI occurred in 0/11 of the TVT group vs. 1/8 (12.5%) in the control group (p > 0.05), and voiding dysfunction occurred in 3/11 patients of the TVT group (27.3%) vs. 0/8 in the control group (p < 0.05). Anatomic success on prolapse was 88.5% (23/26) and 86.4% (19/22) in the TVT and the control group, respectively (p > 0.05).

CONCLUSION

In patients with preoperative SUI, TVT is more efficient than prosthetic cystocele repair alone to prevent postoperative SUI, without differences in voiding dysfunction. In patients with preoperative occult SUI, prosthetic cystocele repair is as efficient as TVT, with a decreased risk of voiding dysfunction.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Antoine Beclere Hospital, Clamart, France. renaud.detayrac@abc.ap-hop-paris.frNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

15453892

Citation

de Tayrac, Renaud, et al. "Combined Genital Prolapse Repair Reinforced With a Polypropylene Mesh and Tension-free Vaginal Tape in Women With Genital Prolapse and Stress Urinary Incontinence: a Retrospective Case-control Study With Short-term Follow-up." Acta Obstetricia Et Gynecologica Scandinavica, vol. 83, no. 10, 2004, pp. 950-4.
de Tayrac R, Gervaise A, Chauveaud-Lambling A, et al. Combined genital prolapse repair reinforced with a polypropylene mesh and tension-free vaginal tape in women with genital prolapse and stress urinary incontinence: a retrospective case-control study with short-term follow-up. Acta Obstet Gynecol Scand. 2004;83(10):950-4.
de Tayrac, R., Gervaise, A., Chauveaud-Lambling, A., & Fernandez, H. (2004). Combined genital prolapse repair reinforced with a polypropylene mesh and tension-free vaginal tape in women with genital prolapse and stress urinary incontinence: a retrospective case-control study with short-term follow-up. Acta Obstetricia Et Gynecologica Scandinavica, 83(10), 950-4.
de Tayrac R, et al. Combined Genital Prolapse Repair Reinforced With a Polypropylene Mesh and Tension-free Vaginal Tape in Women With Genital Prolapse and Stress Urinary Incontinence: a Retrospective Case-control Study With Short-term Follow-up. Acta Obstet Gynecol Scand. 2004;83(10):950-4. PubMed PMID: 15453892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined genital prolapse repair reinforced with a polypropylene mesh and tension-free vaginal tape in women with genital prolapse and stress urinary incontinence: a retrospective case-control study with short-term follow-up. AU - de Tayrac,Renaud, AU - Gervaise,Amelie, AU - Chauveaud-Lambling,Aurelia, AU - Fernandez,Herve, PY - 2004/9/30/pubmed PY - 2004/10/30/medline PY - 2004/9/30/entrez SP - 950 EP - 4 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 83 IS - 10 N2 - BACKGROUND: To evaluate the tension-free vaginal tape (TVT) in both stress urinary incontinence (SUI) and occult SUI as an associated procedure at the time of tension-free polypropylene mesh repair for the treatment of genitourinary prolapse. METHODS: Forty-eight consecutive women undergoing surgery for genital prolapse and concurrent SUI from November 1999 to September 2002. Preoperatively, SUI was symptomatic in 29 women and occult in 19, with a positive stress test during repositioning of the prolapse. All patients had urethral hypermobility and none had intrinsic sphincter deficiency. The cystocele repair was performed in all patients according to the technique of tension-free polypropylene mesh. Twenty-six women had an associated TVT and 22 had no associated procedure for SUI (control group). The main outcome measures were postoperative SUI, voiding dysfunction, and recurrence of prolapse. RESULTS: The median follow-up was 20 +/- 10.1 months (range 7-41). Patient characteristics and preoperative urodynamic evaluation were similar in the two groups. In patients with preoperative SUI, postoperative SUI occurred in 1/15 of the TVT group (6.7%) vs. 5/14 (35.7%) in the control group (p < 0.05), and voiding dysfunction occurred in 2/15 patients of the TVT group (13.3%) vs. 0/14 in the control group (p > 0.05). In patients with preoperative occult SUI, postoperative SUI occurred in 0/11 of the TVT group vs. 1/8 (12.5%) in the control group (p > 0.05), and voiding dysfunction occurred in 3/11 patients of the TVT group (27.3%) vs. 0/8 in the control group (p < 0.05). Anatomic success on prolapse was 88.5% (23/26) and 86.4% (19/22) in the TVT and the control group, respectively (p > 0.05). CONCLUSION: In patients with preoperative SUI, TVT is more efficient than prosthetic cystocele repair alone to prevent postoperative SUI, without differences in voiding dysfunction. In patients with preoperative occult SUI, prosthetic cystocele repair is as efficient as TVT, with a decreased risk of voiding dysfunction. SN - 0001-6349 UR - https://www.unboundmedicine.com/medline/citation/15453892/Combined_genital_prolapse_repair_reinforced_with_a_polypropylene_mesh_and_tension_free_vaginal_tape_in_women_with_genital_prolapse_and_stress_urinary_incontinence:_a_retrospective_case_control_study_with_short_term_follow_up_ L2 - https://doi.org/10.1111/j.0001-6349.2004.00499.x DB - PRIME DP - Unbound Medicine ER -