Using TVT Procedure in Combination with Anterior Colporrhapy for Management of Cystocele Combined with Stress Urinary Incontinence: Preliminary Results

PURPOSE: We performed a preliminary study to assess the possibility of using Tension-free vaginal tape (TVT) procedure in combination with repair of cystocele (anterior colporrhapy) for management of cystocele and stress urinary incontinence. MATERIALS AND METHODS: Twelve clinically incontinent women with cystocele were prospectively enrolled. In addition to anterior colporrhapy, these patients underwent concomittant TVT procedure. Among them, ten patients were evaluated preoperatively and postoperatively by questionnaires, urodynamic study, 1 hour pad test, physical examination and urinalysis. The stress urinary incontinence was classified into two categories: anatomical incontinence and intrinsic sphincter deficiency. The cystocele was staged by the POP-Q system. RESULTS: The mean follow-up interval was 12.2 months (8.3~18.6 months) and the mean age was 57.5 years(45~68 years). All patients had anatomical incontinence. Mean pre- and post-operative Valsalva leak point pressure (VLPP) was 101.1 cmH2O (96~127 cmH2O) and no leakage respectively. And mean pre- and post-operative 1 hour pad test was 10.4 g (1.3~40.9 g) and 1.0 g (0.0~1.9 g) respectively. All cystocele staged by POP-Q system was stage II. The mean Aa point was -0.18 cm (-0.5~ +0.2 cm) preoperatively and lower than -1 cm postoperatively. Only one de novo urgency was developed postoperatively, which was resolved by the use of anticholinergic agent. Other severe intra- and post-operative complications were not observed. CONCLUSION: This study demonstrates that TVT combined with anterior colporrhapy can be performed to treat effectively symptoms of cystocele and stress urinary incontinenece.

The value of cough test during the tension-free vaginal tape procedure / 重庆医科大学学报

Objective: To discuss the practical value of cough test during the tension-free vaginal tape(TVT) procedure.Methods: 27 operations were performed according to the Ulmsten's method strictly,only that the stress of tape was adjusted in the light of cough test.The tape without stress was put down the urethral tract in other 18 operations,not adjusted by cough test.Results: 2 cases of urinary retention and 2 cases of difficulty of urination were found in the group of 27 cases,while difficulty of urination did not appear in other 18 cases.Conclusion: Adjusting stress of tape in accordance with cough test during the TVT can increase the opportunity of urinary retention or difficulty of urination after operation.

The tension-free vaginal tape procedure for the treatment of stress incontinence in the female patient / 重庆医科大学学报

Objective:To assess the effects after the tension-free vaginal tape (TVT) procedure in women with urinary incontience.Methods:37 patients with stress incontinence underwent the TVT procedure.Results:The patients have been followed up for 3～16 months.All were cured by the TVT procedure.The main postoperative complication was retention (in 2 patients).Conlusion:Our results demonstrate that the TVT procedure is a safe and effective method for the treatment of stress incontinence in the female patient.