1703 CHANGES IN CLITORIAL BLOOD FLOW FOLLOWING SURGERY WITH TENSION-FREE VAGINAL MESH FOR PELVIC ORGAN PROLAPSE

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology1 Apr 20111703 CHANGES IN CLITORIAL BLOOD FLOW FOLLOWING SURGERY WITH TENSION-FREE VAGINAL MESH FOR PELVIC ORGAN PROLAPSE Toyohiko Watanabe, Miyabi Inoue, Ayano Ishii, Toyoko Yamato, Motoo Araki, Shinya Uehara, Takashi Saika, Yasutomo Nasu, and Hiromi Kumon Toyohiko WatanabeToyohiko Watanabe Okayama, Japan More articles by this author , Miyabi InoueMiyabi Inoue Okayama, Japan More articles by this author , Ayano IshiiAyano Ishii Okayama, Japan More articles by this author , Toyoko YamatoToyoko Yamato Okayama, Japan More articles by this author , Motoo ArakiMotoo Araki Okayama, Japan More articles by this author , Shinya UeharaShinya Uehara Okayama, Japan More articles by this author , Takashi SaikaTakashi Saika Okayama, Japan More articles by this author , Yasutomo NasuYasutomo Nasu Okayama, Japan More articles by this author , and Hiromi KumonHiromi Kumon Okayama, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1894AboutPDF 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 The study was conducted with 30 patients who underwent TVM for surgical correction of pelvic organ prolapse. Doppler ultrasonography was performed using a commercially available color Doppler scanner (prosound α-7, ALOKA, Tokyo, JAPAN) with a 12 mHz linear array transducer. 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, 6 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 and RI, which reflect blood flow impedance, increased and both parameters significantly decreased 6 months after surgery. (P<0.05). On the other hand, the mean PSV and EDV decreased one month after surgery, and then increased at 6 months after surgery. These 4 parameters recovered at 6 months after surgery. Total FSFI scores were deteriorated from 10.2±7.9 at baseline to 7.0±4.3 at 3 months, and then improved significantly to 18.2±8.9 at 6 months after surgery. As the PI and RI decreased, FSFI scores tended to increase; and they also tended to increase as the PSV and EDV 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 6 M after TVM PI 1.20±0.31 1.50±042* 1.18±0.23 1.06±0.39 RI 0.72±0.08 0.84±0.14* 0.70±0.05 0.64±0.08 PSV (cm/sec.) 10.9±6.2 7.7±2.5* 9.3±2.0 9.7±2.5 EDV (cm/sec.) 3.1±2.2 1.7±1.4* 2.8±0.6 3.2±0.8 FSFI 10.2±7.9 (-) 7.0±4.3 18.2±8.9* * P<0.05 © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e685 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toyohiko Watanabe Okayama, Japan More articles by this author Miyabi Inoue Okayama, Japan More articles by this author Ayano Ishii Okayama, Japan More articles by this author Toyoko Yamato Okayama, Japan More articles by this author Motoo Araki Okayama, Japan More articles by this author Shinya Uehara Okayama, Japan More articles by this author Takashi Saika Okayama, Japan More articles by this author Yasutomo Nasu Okayama, Japan More articles by this author Hiromi Kumon Okayama, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...