Anatomy of the female pelvic viscera before and after transobturator tape procedures and anterior vaginal wall repair in patients with stress urinary incontinence

Abstract

Anatomy of the female pelvic viscera was investigated before and after the Tension free Vaginal tape (TVT-O). Forty patients were included in the study. Surgery was performed between 2009 and 2012 in Clinic of Urology (Clinical Center Nis) and Department of Urology (Municipal Hospital Prokuplje). Stress Urinary Incontinence (SUI) and anterior vaginal wall prolapse was confirmed in all patients. In all patients with anterior vaginal wall prolapse (grade≥2) both tension free vaginal tape (TVT-O) and anterior vaginal wall repair were performed. Pelvic Organ Prolapse Quantification (POPQ) system was used for the evaluation of prolapse before and after the surgery. Mean age of patients was 61 years. Spinal anesthesia was performed in thirty patients and general anesthesia in 10 patients. Intraoperative blood loss was under 50 ml. There were no bladder, nerve and blood vessels injuries . Thirty eight out of forty patients (95%) were satisfied with the outcome of the surgery. There was a significant correction of prolapse after the surgery. Recurrence of prolapse was found in patients with the high grade prolapse before the surgery, as well as, in patients with the history of previous anterior vaginal repair. Pelvic organ prolapse, congenital or acquired, is supported by the congenital weakness of the pelvic floor.