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. © 2008 AAGL.

Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele / Marzio Angelo, Zullo; Alfonso, Ruggiero; Francesco, Plotti; Bellati, Filippo; Stefano, Basile; Natalina, Manci; Muzii, Ludovico; Roberto, Angioli; BENEDETTI PANICI, Pierluigi. - In: JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY. - ISSN 1553-4650. - STAMPA. - 15:4(2008), pp. 446-451. [10.1016/j.jmig.2008.03.014]

Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele

BELLATI, FILIPPO;MUZII, LUDOVICO;BENEDETTI PANICI, PIERLUIGI
2008

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. © 2008 AAGL.
urogenital prolapse; stress urinary incontinence; colporrhaphy; cystocele; transobturator tension-free vaginal tape
01 Pubblicazione su rivista::01a Articolo in rivista
Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele / Marzio Angelo, Zullo; Alfonso, Ruggiero; Francesco, Plotti; Bellati, Filippo; Stefano, Basile; Natalina, Manci; Muzii, Ludovico; Roberto, Angioli; BENEDETTI PANICI, Pierluigi. - In: JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY. - ISSN 1553-4650. - STAMPA. - 15:4(2008), pp. 446-451. [10.1016/j.jmig.2008.03.014]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/231640
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