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Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele.
J Minim Invasive Gynecol. 2008 Jul-Aug; 15(4):446-51.JM

Abstract

STUDY OBJECTIVE

To reveal the efficacy and feasibility of concomitant anterior colporrhaphy and tension-free vaginal tape-obturator to treat stress urinary incontinence (SUI) and concomitant cystocele.

DESIGN

Controlled trial without randomization (Canadian Task Force classification II-1).

SETTING

University hospitals in Rome, Italy.

PATIENTS

Fifty consecutive patients with SUI associated with symptomatic cystocele were enrolled into the study. Exclusion criteria were: uterine prolapse greater than or equal to 1, rectocele greater than or equal to 1, overactive bladder, overactive bladder symptoms, intrinsic urethral sphincter deficiency, urinary retention, previous anti-incontinence and/or prolapse surgery, neurologic bladder, psychiatric disease, body mass index greater than 30, and elevated intraabdominal pressure. The preoperative evaluation consisted of: complete history, physical examination, 3-day voiding diary, and urodynamic testing. The International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI SF) was used to subjectively quantify the patient perception of SUI symptom severity.

INTERVENTIONS

All patients underwent an ultralateral anterior colporrhaphy plus tension-free vaginal tape-obturator.

MEASUREMENTS AND MAIN RESULTS

In all, 43 (91%) and 46 (92%) patients were objectively cured for cystocele and SUI, respectively. The median operating time, blood loss, and hospitalization were 43 minutes (range 35-56), 64 mL (range 40-148), and 1 day (range 1-2), respectively. Overall early postoperative complication rate was 16%, although all were minor. Only 1 patient, at 12-month follow-up, developed tape erosion that required surgical removal. The ICIQ-UI SF questionnaire scores were 13.4 +/- 6.8 and 3.5 +/- 3.2 (p <.01) between preoperative and 12-month follow-up, respectively.

CONCLUSION

Concomitant tension-free vaginal tape-obturator plus ultralateral anterior colporrhaphy are feasible and safe procedures for the treatment of SUI and with associated cystocele with a high success rate and low intraoperative and postoperative complications rate.

Authors+Show Affiliations

Departments of Obstetrics and Gynecology at Campus Bio Medico, University of Rome, Italy. m.zullo@unicampus.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

18539091

Citation

Zullo, Marzio Angelo, et al. "Anterior Colporrhaphy Plus Inside-out Tension-free Vaginal Tape for Associated Stress Urinary Incontinence and Cystocele." Journal of Minimally Invasive Gynecology, vol. 15, no. 4, 2008, pp. 446-51.
Zullo MA, Ruggiero A, Plotti F, et al. Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele. J Minim Invasive Gynecol. 2008;15(4):446-51.
Zullo, M. A., Ruggiero, A., Plotti, F., Bellati, F., Basile, S., Manci, N., Muzii, L., Angioli, R., & Panici, P. B. (2008). Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele. Journal of Minimally Invasive Gynecology, 15(4), 446-51. https://doi.org/10.1016/j.jmig.2008.03.014
Zullo MA, et al. Anterior Colporrhaphy Plus Inside-out Tension-free Vaginal Tape for Associated Stress Urinary Incontinence and Cystocele. J Minim Invasive Gynecol. 2008 Jul-Aug;15(4):446-51. PubMed PMID: 18539091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele. AU - Zullo,Marzio Angelo, AU - Ruggiero,Alfonso, AU - Plotti,Francesco, AU - Bellati,Filippo, AU - Basile,Stefano, AU - Manci,Natalina, AU - Muzii,Ludovico, AU - Angioli,Roberto, AU - Panici,Pierluigi Bendetti, Y1 - 2008/06/06/ PY - 2008/01/18/received PY - 2008/03/22/revised PY - 2008/03/29/accepted PY - 2008/6/10/pubmed PY - 2008/11/19/medline PY - 2008/6/10/entrez SP - 446 EP - 51 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 15 IS - 4 N2 - STUDY OBJECTIVE: To reveal the efficacy and feasibility of concomitant anterior colporrhaphy and tension-free vaginal tape-obturator to treat stress urinary incontinence (SUI) and concomitant cystocele. DESIGN: Controlled trial without randomization (Canadian Task Force classification II-1). SETTING: University hospitals in Rome, Italy. PATIENTS: Fifty consecutive patients with SUI associated with symptomatic cystocele were enrolled into the study. Exclusion criteria were: uterine prolapse greater than or equal to 1, rectocele greater than or equal to 1, overactive bladder, overactive bladder symptoms, intrinsic urethral sphincter deficiency, urinary retention, previous anti-incontinence and/or prolapse surgery, neurologic bladder, psychiatric disease, body mass index greater than 30, and elevated intraabdominal pressure. The preoperative evaluation consisted of: complete history, physical examination, 3-day voiding diary, and urodynamic testing. The International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI SF) was used to subjectively quantify the patient perception of SUI symptom severity. INTERVENTIONS: All patients underwent an ultralateral anterior colporrhaphy plus tension-free vaginal tape-obturator. MEASUREMENTS AND MAIN RESULTS: In all, 43 (91%) and 46 (92%) patients were objectively cured for cystocele and SUI, respectively. The median operating time, blood loss, and hospitalization were 43 minutes (range 35-56), 64 mL (range 40-148), and 1 day (range 1-2), respectively. Overall early postoperative complication rate was 16%, although all were minor. Only 1 patient, at 12-month follow-up, developed tape erosion that required surgical removal. The ICIQ-UI SF questionnaire scores were 13.4 +/- 6.8 and 3.5 +/- 3.2 (p <.01) between preoperative and 12-month follow-up, respectively. CONCLUSION: Concomitant tension-free vaginal tape-obturator plus ultralateral anterior colporrhaphy are feasible and safe procedures for the treatment of SUI and with associated cystocele with a high success rate and low intraoperative and postoperative complications rate. SN - 1553-4650 UR - https://www.unboundmedicine.com/medline/citation/18539091/Anterior_colporrhaphy_plus_inside_out_tension_free_vaginal_tape_for_associated_stress_urinary_incontinence_and_cystocele_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(08)00157-X DB - PRIME DP - Unbound Medicine ER -