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DOI: 10.1055/s-0029-1224661
© Georg Thieme Verlag Stuttgart ˙ New York
Transvaginal Mesh (TVM) Reconstruction with TVT / TOT Sling for Vaginal Prolapse Concurrent with Stress Urinary Incontinence
Transvaginale Mesh (TVM) Rekonstruktion mit TVT / TOT Schlinge bei Vaginalprolaps in Kombination mit StressinkontinenzPublication History
Publication Date:
21 January 2010 (online)
Abstract
We evaluated clinical efficacies of transvaginal mesh (TVM) reconstruction alone and those concomitant with a TVT / TOT sling for the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Between January 2006 and February 2007, 138 female patients with POP underwent TVM reconstruction. The mean age was 66.6 years (range: 52–84). Fourteen individuals were qualified as grade II in the POP quantification (POP-Q) system, 85 and 39 were grades III and IV, respectively. One hundred and seventeen of 138 (85 %) cases showed SUI. Twenty-one patients without SUI underwent TVM alone, and 117 cases with SUI underwent TVM concomitant with TVT / TOT sling. Mean operation time and intraoperative bleeding was 79 min (range: 25–177) and 74 ml (range: 10–429), respectively. Mean follow-up period is 5.3 months (range: 1–14). The vaginal prolapses were cured (grade 0) in 129 cases (93 %) after the surgery. Total international prostate symptom score (IPSS), its QOL score, International Consultation on Incontinence Questionnaires Short Form (ICIQ-SF) significantly improved (from 12.6 to 3.9; p < 0.0001, from 5.0 to 1.0; p < 0.0001, and from 6.1 to 2.5; p < 0.01, respectively). Six of 21 cases (29 %) who underwent TVM alone showed postoperative de-novo SUI. In contrast, 116 cases (99 %) who underwent TVM concomitant with TVT / TOT, experienced a cure of SUI. Maximum flow rate did not change postoperatively in the both groups. In conclusion, the short-term efficacies of TVM reconstruction for POP are excellent, and a concomitant TVT / TOT sling prevents postoperative SUI.
Key words
pelvic organ prolapse - tension-free vaginal mesh - trans-obturator tape
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S. TakahashiM. D.
Department of Urology · Nihon University School of Medicine
30–1, Oyaguchikamimachi, Itabashi-ku
Tokyo, 173–8610
Phone: +81 / 3 / 39 72 81 11
Fax: +81 / 3 / 39 72 59 70
Email: tsatoru@med.nihon-u.ac.jp