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- Title
Urodynamic and clinical effects of transvaginal mesh repair for severe cystocele with and without urinary incontinence
- Authors
Liang, Ching-Chung; Lin, Yi-Hao; Chang, Yao-Lung; Chang, Shuenn-Dhy
- Abstract
<bold>Objective: </bold>To demonstrate the urodynamic and clinical effects of transvaginal polypropylene mesh repair (TVM) for severe cystocele with or without stress urinary incontinence (SUI).<bold>Methods: </bold>One hundred women with severe cystocele who underwent transvaginal cystocele repair using a tension-free polypropylene mesh were included in a retrospective study. A simultaneous transobturator tape (TOT) procedure was performed in 24 patients with concurrent urodynamic stress incontinence (USI). Postoperative follow-up examinations included urodynamic testing, pelvic organ prolapse quantification, and urogynecologic questionnaire.<bold>Results: </bold>Mean follow-up was 35 months (range, 13-68 months). At 3-6 months after surgery, 2 (8.3%) of the 24 patients with USI who had undergone TVM and TOT had persistent SUI. Of the 30 women with occult USI who had undergone TVM alone, 6 (20%) developed symptomatic SUI and 9 (30%) had asymptomatic SUI. Thirteen (28.3%) of the 46 patients without USI developed postoperative SUI. The 1-year results showed de novo SUI in 10 (10%) women, recurrent cystocele in 6 (6%), and mesh erosions in 5 (5%). Four (13.3%) of the 30 patients engaging in sexual activity had dyspareunia.<bold>Conclusion: </bold>TVM is effective and safe in patients with severe cystocele, but may have an impact on voiding and sexual activity.
- Subjects
CYSTOCELE; URODYNAMICS; URINARY incontinence; TREATMENT effectiveness; DISEASES in women; POLYPROPYLENE; DYSPAREUNIA; MEDICAL statistics; THERAPEUTICS; UTERINE prolapse; POLYENES; GYNECOLOGIC surgery; ARTIFICIAL implants; HUMAN sexuality; TREATMENT of urinary stress incontinence; RETROSPECTIVE studies; SURGICAL meshes; DISEASE complications; SURGERY
- Publication
International Journal of Gynecology & Obstetrics, 2011, Vol 112, Issue 3, p182
- ISSN
0020-7292
- Publication type
journal article
- DOI
10.1016/j.ijgo.2010.09.011