ABSTRACT
AIM: The aim of this paper was to evaluate the short-term outcomes of tension-free vaginal tape procedures in female stress urinary incontinence with intrinsic sphincter deficiency, and to identify possible effective factors for cure rate of this treatment. METHODS: Forty-nine women who underwent tension-free vaginal tape procedures due to urodynamically proven stress urinary incontinence with intrinsic sphincter deficiency were included in this study. All women were followed up at 6 months postoperatively. Outcomes were evaluated by cough/Valsalva stress test, incontinence-related quality of life forms (Incontinence Impact Questionnaire and Urogenital Distress Inventory). Procedure-related complications were noted. Multivariable regression was used to identify the odds for poor surgical outcome. RESULTS: In 49 patients, postoperative quality of life scores decreased significantly as compared with preoperative scores. Forty-one (83.7%) patients were found as cured, while 3 (6.1%) women were in failure. The complaints decreased in 5 (10.2%) women, postoperativeley. Low maximal urethral clossure pressure measured by urodynamics was found as a significant effective factor for poor surgical outcome. CONCLUSION: Tension-free vaginal tape is an effective minimal invasive surgical procedure with low complication incidence for female stress urinary incontinence with intrinsic sphincter deficiency in short term. However, intrinsic sphincter deficiency patients with low maximal urethral closure pressure should be informed preoperatively about possible poor outcomes.
Subject(s)
Suburethral Slings , Urinary Bladder Diseases/surgery , Urinary Incontinence, Stress/surgery , Adult , Female , Follow-Up Studies , Humans , Middle Aged , Quality of Life , Severity of Illness Index , Surveys and Questionnaires , Treatment Outcome , Urethral Diseases/etiology , Urinary Bladder Diseases/complications , Urinary Bladder Diseases/diagnosis , Urinary Incontinence, Stress/complications , Urinary Incontinence, Stress/diagnosis , Urodynamics , Urologic Surgical Procedures/methodsABSTRACT
AIM: Few studies have demonstrated the effects of the sacrospinous ligament fixation (SLF) in the long-term period. Aim of the study was to evaluate the short- and long-term outcomes of SLF. METHODS: This was a longitudinal cohort study. Fifty-one patients who had undergone SLF were evaluated postoperatively at 1 and 7 years. The characteristics of patients, intra- and postoperative complications, length of hospital stay period, short and long-term outcomes of the surgeries were recorded. Objective success was evaluated by vaginal and POP-Q examination at 1 and 7 years postoperatively. RESULTS: Out of 51 patients, 46 (90.19%) patients underwent vaginal hysterectomy, 36 (70.58%) patients anterior colporrhaphy, 31 (60.78%) patients posterior colporrhaphy and 11 (21.56%) patients transobturator tape concomitantly with SLF. The differences of Aa, Ba, Ap, Bp and total vaginal length (TVL) scores between preoperative, postoperative at 1 and 7 years were statistically significant (P<0.001). Cystocele rate, at 1 year and at 7 years, were 8 out of 51 (15.68%) and 9 out of 35 (25.71%), respectively. The objective cure rate for the apical vaginal vault prolapse at 1 year and at 7 years were 96% (49/51) and 94.28% (33 /35), respectively. CONCLUSION: SLF is an appropriate and safe treatment procedure in patients with vaginal vault prolapse in the seven years of follow-up period.
