Prognostic value of urethral mobility and valsalva leak point pressure for female transobturator sling procedure
Int. braz. j. urol
;
38(5): 667-673, Sept.-Oct. 2012. ilus, graf, tab
Artículo
en Inglés
| LILACS
| ID: lil-655994
ABSTRACT
PURPOSE:
To analyze the influence of urethral mobility and Valsalva leak point pressure on postoperative outcomes of transobturator sling (TOT) for female stress urinary incontinence. MATERIALS ANDMETHODS:
A prospective cohort was conducted including 66 patients submitted to TOT from March 2006 to May 2009. Urethral hypermobility was defined as mobility ≥ 30º on Q-tip test, and Valsalva leak point pressure (VLPP) was classified as greater than 60 cmH2O or 60 and less on preoperative urodynamics. These parameters were compared through well defined postoperative objective and subjective success criteria. Intensity of urinary leakage and quality of life was analysed by ICIQ-SF. Statistical analysis was accomplished and the results rendered significant if p < 0.05.RESULTS:
Mean follow up was 10 months (3 to 28). Mean age was 55 years (33 to 80), 70% were white and 30% African descendent, mean body mass index was 27 (21 to 38), average vaginal and abdominal deliveries were 2.8 and 0.5 respectively. A quarter had prior stress incontinence surgery. Patients with urethral hypermobility had higher objective success rates (98% versus 81.25%, p = 0.04). The subjective success rate was also greater in the hypermobility group (84% versus 62.5%), but statistical significance was not reached (p = 0.07). VLPP had no influence on either objective or subjective postoperative success rates (p = 0.17 and 0.34, respectively). In the subgroup analysis, those with low mobility and high VLPP had worse objective success rates in comparison to the group with hypermobility and low VLPP (p = 0.04) and also in relation to the remaining of the studied population. Other possible prognostic factors (previous surgery, mixed incontinence, gestational status) had no influence on success rates.CONCLUSIONS:
High urethral mobility, regardless of the sphincteric status indicated by VLPP, is a favorable prognostic factor for tension-free transobturator tape procedure. No relationship was demonstrated between postoperative success rates and VLPP.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Uretra
/
Incontinencia Urinaria de Esfuerzo
/
Maniobra de Valsalva
/
Cabestrillo Suburetral
Límite:
Adulto
/
Anciano
/
Aged80
/
Femenino
/
Humanos
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2012
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Ipiranga Hospital/BR
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