Preoperative Valsava leak point pressure may not predict outcome of mid-urethral slings: analysis from a randomized controlled trial of retropubic versus transobturator mid-urethral slings
Int. braz. j. urol
; 34(1): 73-83, Jan.-Feb. 2008. tab
Article
in En
| LILACS
| ID: lil-482945
Responsible library:
BR1.1
ABSTRACT
OBJECTIVE:
To test the hypothesis that preoperative Valsalva leak point pressure (VLPP) predicts long-term outcome of mid-urethra slings for female stress urinary incontinence (SUI). MATERIALS ANDMETHODS:
One hundred and forty-five patients with SUI were prospectively randomized to two mid-urethra sling treatments Tension free vaginal tape (TVT) or transobturator tape (TOT). They were followed-up at 3, 6, 12 months post-operatively and then annually for the primary outcome variable, i.e. dry or wet and secondary outcome variables such as scores on the urogenital distress inventory (UDI-6) and the impact of incontinence on quality of life (IIQ-7) questionnaire as well as patient satisfaction as scored on a visual analogue scale (VAS). Preoperative VLPP was correlated with primary and secondary outcome variables.RESULTS:
Mean follow-ups were 32 + 12 months (range 12-55) for TVT and 31 + 15 months (range 12-61) for TOT. When patients were analyzed according to VLPP stratification, 95 (65.5 percent) patients showed a VLPP > 60 cm H2O and 50 (34.5 percent) patients had a VLPP < 60 cm H2O. The overall objective cure rates were 75.8 percent for patients with VLPP > 60 cm H2O and 72 percent for those with VLPP < 60 cm H2O (p < 0.619). No significant differences in objective cure rates emerged when patients were stratified for pre-operative VLPP and matched for TOT or TVT procedures VLPP > 60 cm H2O (82 percent vs. 68.9 percent p < 0.172); VLPP < 60 cm H2O (68 percent vs. 76 percent p < 0.528).CONCLUSIONS:
When patients were stratified for preoperative VLPP (< or > of 60 cm H2O), preoperative VLPP was not linked to outcome after TVT or TOT procedures.Key words
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Urethra
/
Urinary Incontinence, Stress
/
Preoperative Care
/
Valsalva Maneuver
/
Suburethral Slings
Type of study:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Female
/
Humans
Language:
En
Journal:
Int. braz. j. urol
Journal subject:
UROLOGIA
Year:
2008
Document type:
Article
Affiliation country:
Italy
Country of publication:
Brazil