Concomitant trocar-guided transvaginal mesh surgery with a midurethral sling in treating advanced pelvic organ prolapse associated with stress or occult stress urinary incontinence

被引：10

作者：

Wu, Chia-Jen ^{[1
]}

Chuang, Fei-Chi ^{[2
,3
]}

Chu, Li-Ching ^{[1
]}

Kung, Fu-Tsai ^{[2
,3
]}

Huang, Kuan-Hui ^{[2
,3
]}

Wu, Ming-Ping ^{[4
,5
,6
]}

机构：

[1] Chang Gung Mem Hosp, Dept Obstet & Gynecol, Chiayi, Taiwan

[2] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Obstet & Gynecol, Kaohsiung 833, Taiwan

[3] Chang Gung Univ, Coll Med, Kaohsiung, Taiwan

[4] Chi Mei Fdn Hosp, Dept Obstet & Gynecol, Div Urogynecol & Pelv Floor Reconstruct, Tainan 710, Taiwan

[5] Taipei Med Univ, Dept Obstet & Gynecol, Coll Med, Taipei, Taiwan

[6] Chia Nan Univ Pharm & Sci, Ctr Gen Educ, Tainan, Taiwan

来源：

TAIWANESE JOURNAL OF OBSTETRICS & GYNECOLOGY | 2013年 / 52卷 / 04期

关键词：

midurethral sling; occult stress urinary incontinence; pelvic organ prolapse; stress urinary incontinence; transvaginal mesh; FREE VAGINAL TAPE; GENITAL PROLAPSE; CONTINENT WOMEN; RECONSTRUCTIVE SURGERY; URODYNAMIC ASSESSMENT; REPAIR; HYSTERECTOMY; TVT; COMPLICATIONS; MANAGEMENT;

D O I：

10.1016/j.tjog.2013.10.011

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: The purpose of this study was to evaluate the efficacy and feasibility of concomitant trocar-guided transvaginal mesh (TVM) surgery with a midurethral sling (MUS) for treating women with advanced pelvic organ prolapse (POP) and stress urinary incontinence (SUI) or occult SUI (OSUI). Materials and methods: Eighty-nine women with advanced POP and SUI or OSUI were retrospectively enrolled. The Total Prolift and Tension-free Vaginal Tape-Obturator Systems were used for trocar-guided TVM surgery and MUS. Patients received regular follow-up at 1 week, and 1 month, 3 months, 6 months, and 12 months postoperatively, and then annually thereafter. The endpoints were the success rate for POP, and perioperative and postoperative complications. Functional outcomes were the presence of voiding difficulty, persistent or de novo overactive bladder symptoms, postoperative SUI, and paresthesia. Results: The median follow-up period was 35 months (range, 12-50 months). Within the follow-up period, 84 patients (94.4%) were objectively cured, five patients (5.6%) had vaginal apical mesh exposure, 29 individuals (32.6%) had persistent or de novo overactive bladder symptoms, six individuals (22.5%) had de novo SUI (two were found by urodynamics), and nine individuals (10.1%) had voiding difficulties (two were found by urodynamics). In addition, the vaginal hysterectomy group had greater blood loss, longer operation times, and a higher mesh erosion rate compared to the uterine suspension group. Conclusion: Concomitant trocar-guided TVM surgery and MUS with the use of total Prolift and Tension-free Vaginal Tape-Obturator offer good efficacy in treating women with advanced POP and SUI or OSUI. The vaginal hysterectomy group had more perioperative complications. (C) Copyright 2013, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.

引用

页码：516 / 522

页数：7

共 45 条

[1] Incontinence and detrusor dysfunction associated with pelvic organ prolapse: clinical value of preoperative urodynamic evaluation [J].

Araki, Isao ;

Haneda, Yaburu ;

Mikami, Yuki ;

Takeda, Masayuki .

INTERNATIONAL UROGYNECOLOGY JOURNAL, 2009, 20 (11) :1301-1306

[2] De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair [J].

Aungst, Matthew J. ;

Friedman, Evan B. ;

von Pechmann, Walter S. ;

Horbach, Nicolette S. ;

Welgoss, Jeffrey A. .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2009, 201 (01) :73.e1-73.e7

[3] Relationship between stress urinary incontinence and pelvic organ prolapse [J].

Bai, SW ;

Jeon, MJ ;

Kim, JY ;

Chung, KA ;

Kim, SK ;

Park, KH .

INTERNATIONAL UROGYNECOLOGY JOURNAL AND PELVIC FLOOR DYSFUNCTION, 2002, 13 (04) :256-260

[4] Managing the Urethra at Transvaginal Pelvic Organ Prolapse Repair: A Urodynamic Approach [J].

Ballert, Katie N. ;

Biggs, Grace Y. ;

Isenalumhe, Anthony, Jr. ;

Rosenblum, Nirit ;

Nitti, Victor W. .

JOURNAL OF UROLOGY, 2009, 181 (02) :679-684

[5] Is the use of parasympathomimetics for treating an underactive urinary bladder evidence-based? [J].

Barendrecht, Maurits M. ;

Oelke, Matthias ;

Laguna, Maria P. ;

Michel, Martin C. .

BJU INTERNATIONAL, 2007, 99 (04) :749-752

[6]

Basu M, 2009, INT UROGYNECOL J PEL, V22, P399

[7] THE RISK OF DEVELOPING URINARY STRESS-INCONTINENCE AFTER VAGINAL REPAIR IN CONTINENT WOMEN - A CLINICAL AND URODYNAMIC FOLLOW-UP-STUDY [J].

BORSTAD, E ;

RUD, T .

ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 1989, 68 (06) :545-549

[8] Predicting the need for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapse [J].

Chaikin, DC ;

Groutz, A ;

Blaivas, JG .

JOURNAL OF UROLOGY, 2000, 163 (02) :531-534

[9] Pelvic Organ Prolapse and Overactive Bladder [J].

de Boer, T. A. ;

Salvatore, S. ;

Cardozo, L. ;

Chapple, C. ;

Kelleher, C. ;

van Kerrebroeck, P. ;

Kirby, M. G. ;

Koelbl, H. ;

Espuna-Pons, M. ;

Milsom, I. ;

Tubaro, A. ;

Wagg, A. ;

Vierhout, M. E. .

NEUROUROLOGY AND URODYNAMICS, 2010, 29 (01) :30-39

[10] 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 [J].

de Tayrac, R ;

Gervaise, A ;

Chauveaud-Lambling, A ;

Fernandez, H .

ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2004, 83 (10) :950-954

← 1 2 3 4 5 →