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Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence.
Int J Urol. 2007 Dec; 14(12):1076-9.IJ

Abstract

AIM

We report the clinical and urodynamic outcomes of the pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence (SUI) and determined the urodynamic parameters that could predict the occurrence of postoperative voiding difficulty.

METHODS

Between 1998 and 2005, a total of 29 consecutive women with SUI underwent pubovaginal sling surgery with autologous rectus fascia. Patients were preoperatively and postoperatively evaluated with regard to symptoms and urodynamic findings including uroflowmetry (UFM), postvoid residual urine volume (PVR), filling cystometry (CMG) and pressure flow study (PFS).

RESULTS

Overall SUI was cured in 23 patients (80%) and improved in 3 patients (10%). Three patients (10%) who developed persistent urinary retention or severe voiding difficulty after surgery underwent urethrolysis. Of 17 patients who had urgency before the pubovaginal sling, urgency was cured postoperatively in seven, while de novo urgency appeared in one patient. Maximum flow rate (Qmax) in UFM was significantly decreased (P < 0.05) and PVR was increased (P = 0.08) after surgery. PFS showed a significant increase in detrusor opening pressure and detrusor pressure at Qmax (P < 0.01) after surgery. Eight patients (28%) needed prolonged intermittent self-catheterization. Patients who had PVR >100 mL (P < 0.05) or Qmax < or = 20 mL/s (P = 0.09) in preoperative UFM were more likely to require prolonged intermittent catheterization after surgery.

CONCLUSIONS

The pubovaginal sling procedure with autologous rectus fascia is an effective treatment for SUI. A comparison of preoperative and postoperative urodynamic parameters indicates an increase in urethral resistance after pubovaginal sling surgery. PVR >100 mL and Qmax < or = 20 mL/s before surgery are risk factors for postoperative voiding difficulty.

Authors+Show Affiliations

Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. mitsui68@med.hokudai.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18036043

Citation

Mitsui, Takahiko, et al. "Clinical and Urodynamic Outcomes of Pubovaginal Sling Procedure With Autologous Rectus Fascia for Stress Urinary Incontinence." International Journal of Urology : Official Journal of the Japanese Urological Association, vol. 14, no. 12, 2007, pp. 1076-9.
Mitsui T, Tanaka H, Moriya K, et al. Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence. Int J Urol. 2007;14(12):1076-9.
Mitsui, T., Tanaka, H., Moriya, K., Kakizaki, H., & Nonomura, K. (2007). Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence. International Journal of Urology : Official Journal of the Japanese Urological Association, 14(12), 1076-9.
Mitsui T, et al. Clinical and Urodynamic Outcomes of Pubovaginal Sling Procedure With Autologous Rectus Fascia for Stress Urinary Incontinence. Int J Urol. 2007;14(12):1076-9. PubMed PMID: 18036043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence. AU - Mitsui,Takahiko, AU - Tanaka,Hiroshi, AU - Moriya,Kimihiko, AU - Kakizaki,Hidehiro, AU - Nonomura,Katsuya, PY - 2007/11/27/pubmed PY - 2008/2/21/medline PY - 2007/11/27/entrez SP - 1076 EP - 9 JF - International journal of urology : official journal of the Japanese Urological Association JO - Int J Urol VL - 14 IS - 12 N2 - AIM: We report the clinical and urodynamic outcomes of the pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence (SUI) and determined the urodynamic parameters that could predict the occurrence of postoperative voiding difficulty. METHODS: Between 1998 and 2005, a total of 29 consecutive women with SUI underwent pubovaginal sling surgery with autologous rectus fascia. Patients were preoperatively and postoperatively evaluated with regard to symptoms and urodynamic findings including uroflowmetry (UFM), postvoid residual urine volume (PVR), filling cystometry (CMG) and pressure flow study (PFS). RESULTS: Overall SUI was cured in 23 patients (80%) and improved in 3 patients (10%). Three patients (10%) who developed persistent urinary retention or severe voiding difficulty after surgery underwent urethrolysis. Of 17 patients who had urgency before the pubovaginal sling, urgency was cured postoperatively in seven, while de novo urgency appeared in one patient. Maximum flow rate (Qmax) in UFM was significantly decreased (P < 0.05) and PVR was increased (P = 0.08) after surgery. PFS showed a significant increase in detrusor opening pressure and detrusor pressure at Qmax (P < 0.01) after surgery. Eight patients (28%) needed prolonged intermittent self-catheterization. Patients who had PVR >100 mL (P < 0.05) or Qmax < or = 20 mL/s (P = 0.09) in preoperative UFM were more likely to require prolonged intermittent catheterization after surgery. CONCLUSIONS: The pubovaginal sling procedure with autologous rectus fascia is an effective treatment for SUI. A comparison of preoperative and postoperative urodynamic parameters indicates an increase in urethral resistance after pubovaginal sling surgery. PVR >100 mL and Qmax < or = 20 mL/s before surgery are risk factors for postoperative voiding difficulty. SN - 0919-8172 UR - https://www.unboundmedicine.com/medline/citation/18036043/Clinical_and_urodynamic_outcomes_of_pubovaginal_sling_procedure_with_autologous_rectus_fascia_for_stress_urinary_incontinence_ L2 - https://doi.org/10.1111/j.1442-2042.2007.01909.x DB - PRIME DP - Unbound Medicine ER -