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Treatment of concomitant prolapse and stress urinary incontinence via a transobturator subvesical mesh without independent suburethral tape.
Acta Obstet Gynecol Scand. 2010; 89(2):223-9.AO

Abstract

OBJECTIVE

Evaluate the efficacy of a transobturator subvesical mesh for cystocele in concomitant stress urinary incontinence (SUI).

DESIGN

Longitudinal observational study.

SETTING

Tertiary referral urogynecology center.

POPULATION

One hundred and five women with at least an anterior vaginal wall prolapse and concomitant SUI who underwent surgery.

METHODS

After reduction of prolapse elements, the intervention consisted of a non-absorbable monoprosthesis placement with two transobturator expansions and, if necessary, associated hysterectomy or infraccocygeal sacropexy. No specific procedure was performed for SUI.

MAIN OUTCOME MEASURES

All patients had a physical examination and a subjective symptoms assessment via questionnaire in the preoperative period and at one-year or more after surgery. The pelvic organ prolapse quantification system was used for anatomical results. For SUI, Ingelman-Sundberg classification and cough test were used. Loss of urine was measured by a one-hour pad test. Functional results were evaluated by visual analog scale, quality-of-life questionnaires, including the pelvic floor distress inventory and the pelvic floor impact questionnaire.

RESULTS

Median follow-up was 45 months (range: 12-72). A total of 102 women (97%) were cured of their prolapse, of whom 72 (69%) were cured of their SUI and 13 (12%) showed improvement. Pad test, visual analogic scale and quality-of-life questionnaires were all improved (p < 0.05). Complications consisted of one rectal injury, one transitory urinary retention, and two hematomas. Of the erosions 6% was observed for monofilament polypropylene prostheses.

CONCLUSION

Transvaginal monoprosthesis for the simultaneous correction of prolapse and SUI represents an effective treatment for bulky or recurrent prolapse as well as posthysterectomy vaginal vault prolapse.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Rouen University Hospital, 1, rue de Germont-76031 Rouen Cedex, France. Fabrice.Sergent@chu-rouen.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20059448

Citation

Sergent, Fabrice, et al. "Treatment of Concomitant Prolapse and Stress Urinary Incontinence Via a Transobturator Subvesical Mesh Without Independent Suburethral Tape." Acta Obstetricia Et Gynecologica Scandinavica, vol. 89, no. 2, 2010, pp. 223-9.
Sergent F, Sentilhes L, Resch B, et al. Treatment of concomitant prolapse and stress urinary incontinence via a transobturator subvesical mesh without independent suburethral tape. Acta Obstet Gynecol Scand. 2010;89(2):223-9.
Sergent, F., Sentilhes, L., Resch, B., Verspyck, E., Medeiros, R., Descamps, P., & Marpeau, L. (2010). Treatment of concomitant prolapse and stress urinary incontinence via a transobturator subvesical mesh without independent suburethral tape. Acta Obstetricia Et Gynecologica Scandinavica, 89(2), 223-9. https://doi.org/10.3109/00016340903511043
Sergent F, et al. Treatment of Concomitant Prolapse and Stress Urinary Incontinence Via a Transobturator Subvesical Mesh Without Independent Suburethral Tape. Acta Obstet Gynecol Scand. 2010;89(2):223-9. PubMed PMID: 20059448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of concomitant prolapse and stress urinary incontinence via a transobturator subvesical mesh without independent suburethral tape. AU - Sergent,Fabrice, AU - Sentilhes,Loïc, AU - Resch,Benoît, AU - Verspyck,Eric, AU - Medeiros,Richard, AU - Descamps,Philippe, AU - Marpeau,Loïc, PY - 2010/1/12/entrez PY - 2010/1/12/pubmed PY - 2010/3/5/medline SP - 223 EP - 9 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 89 IS - 2 N2 - OBJECTIVE: Evaluate the efficacy of a transobturator subvesical mesh for cystocele in concomitant stress urinary incontinence (SUI). DESIGN: Longitudinal observational study. SETTING: Tertiary referral urogynecology center. POPULATION: One hundred and five women with at least an anterior vaginal wall prolapse and concomitant SUI who underwent surgery. METHODS: After reduction of prolapse elements, the intervention consisted of a non-absorbable monoprosthesis placement with two transobturator expansions and, if necessary, associated hysterectomy or infraccocygeal sacropexy. No specific procedure was performed for SUI. MAIN OUTCOME MEASURES: All patients had a physical examination and a subjective symptoms assessment via questionnaire in the preoperative period and at one-year or more after surgery. The pelvic organ prolapse quantification system was used for anatomical results. For SUI, Ingelman-Sundberg classification and cough test were used. Loss of urine was measured by a one-hour pad test. Functional results were evaluated by visual analog scale, quality-of-life questionnaires, including the pelvic floor distress inventory and the pelvic floor impact questionnaire. RESULTS: Median follow-up was 45 months (range: 12-72). A total of 102 women (97%) were cured of their prolapse, of whom 72 (69%) were cured of their SUI and 13 (12%) showed improvement. Pad test, visual analogic scale and quality-of-life questionnaires were all improved (p < 0.05). Complications consisted of one rectal injury, one transitory urinary retention, and two hematomas. Of the erosions 6% was observed for monofilament polypropylene prostheses. CONCLUSION: Transvaginal monoprosthesis for the simultaneous correction of prolapse and SUI represents an effective treatment for bulky or recurrent prolapse as well as posthysterectomy vaginal vault prolapse. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/20059448/Treatment_of_concomitant_prolapse_and_stress_urinary_incontinence_via_a_transobturator_subvesical_mesh_without_independent_suburethral_tape_ L2 - https://doi.org/10.3109/00016340903511043 DB - PRIME DP - Unbound Medicine ER -