1512 CLITORIAL BLOOD FLOW CHANGES AFTER SURGERY WITH TENSION-FREE VAGINAL MESH FOR PELVIC ORGAN PROLAPSE

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology I1 Apr 20101512 CLITORIAL BLOOD FLOW CHANGES AFTER SURGERY WITH TENSION-FREE VAGINAL MESH FOR PELVIC ORGAN PROLAPSE Toyohiko Watanabe, Miyabi Inoue, Ayano Ishii, Toyoko Yamato, Hiroyuki Nose, Katsutoshi Uematsu, Katsumi Sasaki, Motoo Araki, Shinya Uehara, Takashi Saika, Yasutomo Nasu, and Hiromi Kumon Toyohiko WatanabeToyohiko Watanabe More articles by this author , Miyabi InoueMiyabi Inoue More articles by this author , Ayano IshiiAyano Ishii More articles by this author , Toyoko YamatoToyoko Yamato More articles by this author , Hiroyuki NoseHiroyuki Nose More articles by this author , Katsutoshi UematsuKatsutoshi Uematsu More articles by this author , Katsumi SasakiKatsumi Sasaki More articles by this author , Motoo ArakiMotoo Araki More articles by this author , Shinya UeharaShinya Uehara More articles by this author , Takashi SaikaTakashi Saika More articles by this author , Yasutomo NasuYasutomo Nasu More articles by this author , and Hiromi KumonHiromi Kumon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1250AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In the previous study, we reported a significant improvement in sexual function outcome following the surgery with tension-free vaginal mesh (TVM) for pelvic organ prolapse (POP). We evaluated the effect of TVM procedure on clitorial blood flow and sexual function in women with POP. METHODS A total of 39 underwent TVM for surgical correction of POP. Seventeen of 39 patients underwent tranlabial color Doppler ultrasonography. The Doppler translabial probe was placed sagittally on the clitoris at an angle of less than 20°, without exerting any significant pressure on the tissues. After identifying the clitoral artery using color flow mapping, the Doppler probe was positioned over the vessel and at least three sequential Doppler waveforms were obtained. We measured the resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the clitoral arteries, before and 1, 3, 12 months postoperatively. Female sexual function was also investigated with the Female Sexual Function Index (FSFI) which was a 19-question, self-report measure, organized in a 6-domain structure, including desire, subjective arousal, lubrication, orgasm, satisfaction, and pain. RESULTS One month after surgery, the mean PI was significantly greater and the mean PSV of the clitoral arteries was significantly lower compared with baseline. (P<0.05). However, the mean PI and mean PSV recovered at 12 months postoperatively. Total FSFI scores was deteriorated from 10.2±7.9 at baseline to 7.0±4.3 at 3 months. However, FSFI scores improved significantly from 10.2±7.9 at baseline to 18.2±8.1 at 6months, 21.4±7.3 at 12 months after surgery. As the resistance index values decreased, FSFI scores tended to increase; and they also tended to increase as flow velocity increased. CONCLUSIONS Color Doppler ultrasonography appears to be feasible and useful in measuring both baseline and post-treatment condition of clitorial blood flow in patients treated with TVM for POP. Further studies are necessary to investigate the effect of clitorial blood flow changes on female sexual function in various clinical settings. Parameter Baseline 1 M after TVM 3 M after TVM 12 M after TVM RI 0.77±0.11 0.86±0.12 0.71±0.06 0.75±0.08 PI 1.37±0.43 1.55±0.34⁎ 1.33±0.19 1.26±0.30 PSV (cm/sec.) 12.38±7.10 8.85±3.10⁎ 8.03±0.76 10.59±2.55 EDV (cm/sec.) 2.89±2.54 1.48±1.13 2.30±0.27 2.59±0.76 FSFI 10.2±7.9 (-) 18.2±8.1⁎⁎ 21.4±7.3⁎ ⁎⁎ 6M after TVM ⁎ P<0.05 Okayama, Japan© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e583 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toyohiko Watanabe More articles by this author Miyabi Inoue More articles by this author Ayano Ishii More articles by this author Toyoko Yamato More articles by this author Hiroyuki Nose More articles by this author Katsutoshi Uematsu More articles by this author Katsumi Sasaki More articles by this author Motoo Araki More articles by this author Shinya Uehara More articles by this author Takashi Saika More articles by this author Yasutomo Nasu More articles by this author Hiromi Kumon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...