Tags

Type your tag names separated by a space and hit enter

Managing the urethra at transvaginal pelvic organ prolapse repair: a urodynamic approach.
J Urol. 2009 Feb; 181(2):679-84.JU

Abstract

PURPOSE

We evaluated the protocol that we use to determine whether a mid urethral synthetic sling will be placed at transvaginal pelvic organ prolapse repair.

MATERIALS AND METHODS

A total of 140 patients underwent transvaginal repair for stage 2 to 4 pelvic organ prolapse, of whom 105 were treated according to the protocol and had a minimum 3 months of followup or required earlier intervention. Urodynamics were performed without prolapse reduction. When stress urinary incontinence was not identified, a pessary was placed and the study was repeated. Patients were designated as having urodynamic, occult or no stress urinary incontinence. Patients with urodynamic or occult stress urinary incontinence underwent a simultaneous mid urethral synthetic sling procedure, while those without urodynamic or occult stress urinary incontinence did not. Charts were reviewed to determine whether further intervention was required for stress urinary incontinence or obstruction.

RESULTS

The risk of intervention due to obstruction after receiving a mid urethral synthetic sling was 8.5%. The risk of intervention for stress urinary incontinence in patients with no clinical, urodynamic or occult stress urinary incontinence and no mid urethral synthetic sling was 8.3%. The risk of intervention for stress urinary incontinence in patients with clinical stress urinary incontinence but no urodynamic or occult stress urinary incontinence and no mid urethral sling was 30%.

CONCLUSIONS

Using our urodynamic protocol to manage the urethra at transvaginal pelvic organ prolapse repair the risk of intervention due to obstruction is essentially equal to the risk of intervention due to stress urinary incontinence when no clinical, urodynamic or occult stress urinary incontinence was present and no mid urethral synthetic sling was placed. In patients who report clinical stress urinary incontinence preoperatively despite no urodynamic or occult stress urinary incontinence there is a much higher rate of further intervention for stress urinary incontinence.

Authors+Show Affiliations

Department of Urology, New York University, New York, New York 10016, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19091337

Citation

Ballert, Katie N., et al. "Managing the Urethra at Transvaginal Pelvic Organ Prolapse Repair: a Urodynamic Approach." The Journal of Urology, vol. 181, no. 2, 2009, pp. 679-84.
Ballert KN, Biggs GY, Isenalumhe A, et al. Managing the urethra at transvaginal pelvic organ prolapse repair: a urodynamic approach. J Urol. 2009;181(2):679-84.
Ballert, K. N., Biggs, G. Y., Isenalumhe, A., Rosenblum, N., & Nitti, V. W. (2009). Managing the urethra at transvaginal pelvic organ prolapse repair: a urodynamic approach. The Journal of Urology, 181(2), 679-84. https://doi.org/10.1016/j.juro.2008.10.009
Ballert KN, et al. Managing the Urethra at Transvaginal Pelvic Organ Prolapse Repair: a Urodynamic Approach. J Urol. 2009;181(2):679-84. PubMed PMID: 19091337.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Managing the urethra at transvaginal pelvic organ prolapse repair: a urodynamic approach. AU - Ballert,Katie N, AU - Biggs,Grace Y, AU - Isenalumhe,Anthony,Jr AU - Rosenblum,Nirit, AU - Nitti,Victor W, Y1 - 2008/12/16/ PY - 2008/05/14/received PY - 2008/12/19/entrez PY - 2008/12/19/pubmed PY - 2009/2/5/medline SP - 679 EP - 84 JF - The Journal of urology JO - J Urol VL - 181 IS - 2 N2 - PURPOSE: We evaluated the protocol that we use to determine whether a mid urethral synthetic sling will be placed at transvaginal pelvic organ prolapse repair. MATERIALS AND METHODS: A total of 140 patients underwent transvaginal repair for stage 2 to 4 pelvic organ prolapse, of whom 105 were treated according to the protocol and had a minimum 3 months of followup or required earlier intervention. Urodynamics were performed without prolapse reduction. When stress urinary incontinence was not identified, a pessary was placed and the study was repeated. Patients were designated as having urodynamic, occult or no stress urinary incontinence. Patients with urodynamic or occult stress urinary incontinence underwent a simultaneous mid urethral synthetic sling procedure, while those without urodynamic or occult stress urinary incontinence did not. Charts were reviewed to determine whether further intervention was required for stress urinary incontinence or obstruction. RESULTS: The risk of intervention due to obstruction after receiving a mid urethral synthetic sling was 8.5%. The risk of intervention for stress urinary incontinence in patients with no clinical, urodynamic or occult stress urinary incontinence and no mid urethral synthetic sling was 8.3%. The risk of intervention for stress urinary incontinence in patients with clinical stress urinary incontinence but no urodynamic or occult stress urinary incontinence and no mid urethral sling was 30%. CONCLUSIONS: Using our urodynamic protocol to manage the urethra at transvaginal pelvic organ prolapse repair the risk of intervention due to obstruction is essentially equal to the risk of intervention due to stress urinary incontinence when no clinical, urodynamic or occult stress urinary incontinence was present and no mid urethral synthetic sling was placed. In patients who report clinical stress urinary incontinence preoperatively despite no urodynamic or occult stress urinary incontinence there is a much higher rate of further intervention for stress urinary incontinence. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19091337/Managing_the_urethra_at_transvaginal_pelvic_organ_prolapse_repair:_a_urodynamic_approach_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2008.10.009?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -