open access

Vol 89, No 4 (2018)
Research paper
Published online: 2018-04-30
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The impact of concurrent pelvic organ prolapse reconstructive surgery on midurethral sling procedure outcome

Buğra Çoşkun1, Orhan S. Aksakal2, Bora Çoşkun3, Engin Yurtçu4, Mehmet Özgür Akkurt5, Özgül Kafadar1, Melike Doğanay2
DOI: 10.5603/GP.a2018.0032
·
Pubmed: 29781073
·
Ginekol Pol 2018;89(4):190-195.
Affiliations
  1. Sincan Nafiz Körfez State Hospital, Ankara, Turkey
  2. University of Health Sciences, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey.
  3. Polatlı State Hospital, Obstetrics and Gynecology Department, Ankara, Turkey
  4. Karabük Research and Education Hospital, Obstetrics and Gynecology Department, Karabük, Turkey
  5. Bursa Yüksek İhtisas Training and Researh Hospital Department of Obstetrics and Gynecology

open access

Vol 89, No 4 (2018)
ORIGINAL PAPERS Gynecology
Published online: 2018-04-30

Abstract

 Objectives: To evaluate the effect of concurrent pelvic organ prolapse (POP) reconstructive surgery on midurethral sling (MUS) procedure outcome.

Material and methods: The present retrospective study included 300 women with urodynamically diagnosed stress urinary incontinence that underwent MUS procedures with or without concurrent POP reconstructive surgery. Patients were divided into four groups according to the performed surgery; 1) transobturator tape (TOT), 2) TOT with POP surgery (anterior colporrhaphy, posterior colporrhaphy and vaginal hysterectomy), 3) tension free vaginal tape (TVT), 4) TVT with POP surgery. Outcomes of surgeries for each group were evaluated postoperatively at the end of the first and sixth month by performing a cough stress test and also using the Incontinence Impact Questionnaire-7 (IIQ-7) and Urogenital Distress Inventory (UDI-6) questionnaires. Presence of a negative cough stress test was defined as “Cure”. Multivariate regression was used to identify the parameters for surgical failure.

Results: Forty-two, 70, 49 and 139 women underwent isolated TOT, concurrent TOT and POP, isolated TVT and concurrent TVT and POP surgery, respectively. Postoperative UDI-6 score and postoperative cure rate were significantly higher in the only TOT group as compared to the TOT + POP group. However, in multiple regression analysis, women’s age, parity, body mass index, menopausal status, preoperative urodynamic parameters, MUS types and presence of any concomitant POP reconstructive surgery were found to have no significant effect on surgical outcome.

Conclusions: Concurrent POP reconstructive surgery including anterior colporrhaphy, posterior colporrhaphy and vaginal hysterectomy have no affect MUS procedure outcomes.

Abstract

 Objectives: To evaluate the effect of concurrent pelvic organ prolapse (POP) reconstructive surgery on midurethral sling (MUS) procedure outcome.

Material and methods: The present retrospective study included 300 women with urodynamically diagnosed stress urinary incontinence that underwent MUS procedures with or without concurrent POP reconstructive surgery. Patients were divided into four groups according to the performed surgery; 1) transobturator tape (TOT), 2) TOT with POP surgery (anterior colporrhaphy, posterior colporrhaphy and vaginal hysterectomy), 3) tension free vaginal tape (TVT), 4) TVT with POP surgery. Outcomes of surgeries for each group were evaluated postoperatively at the end of the first and sixth month by performing a cough stress test and also using the Incontinence Impact Questionnaire-7 (IIQ-7) and Urogenital Distress Inventory (UDI-6) questionnaires. Presence of a negative cough stress test was defined as “Cure”. Multivariate regression was used to identify the parameters for surgical failure.

Results: Forty-two, 70, 49 and 139 women underwent isolated TOT, concurrent TOT and POP, isolated TVT and concurrent TVT and POP surgery, respectively. Postoperative UDI-6 score and postoperative cure rate were significantly higher in the only TOT group as compared to the TOT + POP group. However, in multiple regression analysis, women’s age, parity, body mass index, menopausal status, preoperative urodynamic parameters, MUS types and presence of any concomitant POP reconstructive surgery were found to have no significant effect on surgical outcome.

Conclusions: Concurrent POP reconstructive surgery including anterior colporrhaphy, posterior colporrhaphy and vaginal hysterectomy have no affect MUS procedure outcomes.

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Keywords

concomitant surgery, midurethral sling, outcome, pelvic organ prolapse

About this article
Title

The impact of concurrent pelvic organ prolapse reconstructive surgery on midurethral sling procedure outcome

Journal

Ginekologia Polska

Issue

Vol 89, No 4 (2018)

Article type

Research paper

Pages

190-195

Published online

2018-04-30

DOI

10.5603/GP.a2018.0032

Pubmed

29781073

Bibliographic record

Ginekol Pol 2018;89(4):190-195.

Keywords

concomitant surgery
midurethral sling
outcome
pelvic organ prolapse

Authors

Buğra Çoşkun
Orhan S. Aksakal
Bora Çoşkun
Engin Yurtçu
Mehmet Özgür Akkurt
Özgül Kafadar
Melike Doğanay

References (22)
  1. Gordon D, Gold R, Pauzner D, et al. Tension-free vaginal tape in the elderly: is it a safe procedure? Urology. 2005; 65(3): 479–482.
  2. Jonsson Funk M, Siddiqui NY, Kawasaki A, et al. Long-term outcomes after stress urinary incontinence surgery. Obstet Gynecol. 2012; 120(1): 83–90.
  3. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002; 21(2): 167–178.
  4. Haylen B, Ridder DDe, Freeman R, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Floor Dysfunction. Textbook of Female Urology and Urogynecology, Third Edition. 2013: 1090–1105.
  5. Bing MH, Gimbel H, Greisen S, et al. Clinical risk factors and urodynamic predictors prior to surgical treatment for stress urinary incontinence: a narrative review. Int Urogynecol J. 2015; 26(2): 175–185.
  6. Diokno AC, Brock BM, Brown MB, et al. Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly. J Urol. 1986; 136(5): 1022–1025.
  7. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002; 21(2): 167–178.
  8. Olsen AL, Smith VJ, Bergstrom JO, et al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997; 89(4): 501–506.
  9. Digesu GA, Chaliha C, Salvatore S, et al. The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG. 2005; 112(7): 971–976.
  10. Ulmsten U, Henriksson L, Johnson P, et al. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996; 7(2): 81–86.
  11. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol. 2001; 11(6): 1306–1313.
  12. Maher CM, Feiner B, Baessler K, et al. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J. 2011; 22(11): 1445–1457.
  13. Baden WF, Walker T. Surgical repair of vaginal defects. Lippincott Williams & Wilkins 1992.
  14. Cam C, Sakalli M, Ay P, et al. Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn. 2007; 26(1): 129–133.
  15. Naidu M, Thakar R, Sultan AH. Outcomes of minimally invasive suburethral slings with and without concomitant pelvic organ prolapse surgery. Int J Gynaecol Obstet. 2014; 127(1): 69–72.
  16. Law TSM, Cheung RYK, Chung TKH, et al. Efficacy and outcomes of transobturator tension-free vaginal tape with or without concomitant pelvic floor repair surgery for urinary stress incontinence: five-year follow-up. Hong Kong Med J. 2015; 21(4): 333–338.
  17. Boublil V, Ciofu C, Traxer O, et al. Complications of urethral sling procedures. Curr Opin Obstet Gynecol. 2002; 14(5): 515–520.
  18. Daneshgari F, Kong W, Swartz M. Complications of mid urethral slings: important outcomes for future clinical trials. J Urol. 2008; 180(5): 1890–1897.
  19. Kobashi KC, Govier FE. Perioperative complications: the first 140 polypropylene pubovaginal slings. J Urol. 2003; 170(5): 1918–1921.
  20. Laurikainen E, Valpas A, Kivelä A, et al. Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2007; 109(1): 4–11.
  21. Lo TS. Tension-free vaginal tape procedures in women with stress urinary incontinence with and without co-existing genital prolapse. Curr Opin Obstet Gynecol. 2004; 16(5): 399–404.
  22. Ogah J, Cody DJ, Rogerson L. Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women: a short version Cochrane review. Neurourol Urodyn. 2011; 30(3): 284–291.

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