Abstract
Pelvic organ prolapse (POP) often co-occurs with stress urinary incontinence. There is no consensus on whether prolapse repair and anti-incontinence surgery should be performed concomitantly or separately, in a two-step manner. The present study evaluated the effects of the tension-free vaginal tape (TVT) procedure in patients who had previously undergone pelvic floor repair (study group), compared to women who underwent TVT insertion only (control group). The study group comprised 84 patients who underwent the TVT procedure but had previously also undergone surgical POP repair. The control group consisted of 250 women in whom the TVT was inserted. The primary objective was to compare the objective cure rate and the secondary objective was to compare the subjective cure rate in both groups. Negative pad test was achieved in over 91% in both groups. Objective and subjective cure rates were compared, as well as complication rates. Significant improvement was observed in the postoperative 1-h pad test in all patients. In all patients, we observed significant improvement in the quality of life, with no differences between the groups. No differences were found in the occurrence of postoperative urinary retention, urgency and frequency of daytime micturition, or vaginal erosion between the groups. The current results demonstrate that the two-step approach to pelvic reconstruction and anti-incontinence surgery is as safe and effective as primary TVT implantation.
Highlights
Stress urinary incontinence (SUI) is one of the most common health problems in the adult female population
A total of 334 patients were enrolled in the study, 84 patients who had previously undergone POP repair and 250 who underwent primary tension-free vaginal tape (TVT)
According to the available literature, mid-urethral slings are both more effective and safer than other surgical treatment modalities [12], with objective and subjective cure rates of retropubic TVT ranging from 71% to 97% [13,14]
Summary
Stress urinary incontinence (SUI) is one of the most common health problems in the adult female population. It affects quality of life in many aspects and influences socioeconomical status [1]. Urinary incontinence is often accompanied by other pelvic floor disorders, mainly pelvic organ prolapse [2]. The co-existence of those pathologies is associated with the fact that there are certain pathogenetic risk factors that these two entities have in common, i.e., delivery trauma of pelvic floor muscles and fascias. 40% of woman who undergo prolapse surgery report urinary incontinence postoperatively [3]
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