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Urogenital Prolapse (urogenital + prolapse)
Selected AbstractsSurgical complications and medium-term outcome results of tension-free vaginal tape: A prospective study of 313 consecutive patientsNEUROUROLOGY AND URODYNAMICS, Issue 1 2004Ishai Levin Abstract Objective A prospective study was undertaken to examine the incidence of surgical complications and medium-term outcomes of tension-free vaginal tape (TVT) surgery in a large, heterogeneous group of stress-incontinent women. Methods Surgery was tailored according to preoperative clinical and urodynamic findings: stress-incontinent women underwent TVT surgery, whereas those with concomitant urogenital prolapse underwent combined TVT and prolapse repair. Post-operatively the patients were scheduled for evaluation at 1, 3, 6, and 12 months, and annually thereafter. All underwent urodynamics at 3 months post-operatively. Results Three hundred and thirteen consecutive patients were prospectively studied. The mean follow-up period was 21.4,±,13.5 months. Sixteen (5.1%) cases of intravesical passage of the prolene tape occurred in our series, two of which were diagnosed at 3 and 15 months post-operatively. Eight (2.5%) patients had post-operative voiding difficulties, necessitating catheterization for more than 7 days. However, transvaginal excision of the tape was required in one case only. Vaginal erosion of the tape was diagnosed in four (1.3%) patients, all of whom were successfully treated by local excision of the eroded tape. Outcome analysis was restricted to 241 consecutive patients with at least 12 months of follow-up. Subjectively, 16 (6.6%) patients had persistent mild stress urinary incontinence, although urodynamics revealed asymptomatic sphincteric incontinence in 17 (7%) other patients. De-novo urge incontinence developed post-operatively in 20 (8.3%) patients. Conclusions The TVT procedure is associated with good medium-term cure rates, however, it is not free of troublesome complications and the patients should be informed accordingly. Only well-trained surgeons, familiar with pelvic anatomy, surgical alternatives, and endoscopic techniques should perform the operation. Neurourol. Urodynam. 23:7,9, 2004. © 2003 Wiley-Liss, Inc. [source] Female Sexual Dysfunction in Urogenital Prolapse Surgery: Colposacropexy vs.THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008Hysterocolposacropexy ABSTRACT Introduction., Colposacropexy (CSP), with or without hysterectomy, is a valid technique for the repair of severe urogenital prolapse. For many years, uterine prolapse has represented an indication for hysterectomy, apart from the presence or absence of uterine disease and the patient's desires. Nevertheless, sparing the uterus is essential to women not only to have normal sexual functioning but to maintain physical and anatomical integrity as well. Aim., To assess sexual function in a group of patients who underwent CSP or hysterocolposacropexy (HSP). Materials and Methods., We enrolled 37 patients who underwent surgery for urogenital prolapse (15 HSP, mean age 53 years; 22 CSP, mean age 56 years). Based on a preliminary sexual history and sexual questionnaire, all patients were sexually active before surgery. At a mean follow-up of 39 months, we reassessed the patients using the Female Sexual Function Index (FSFI). Main Outcome Measure., We considered sexual activity with a score of 30 = good, 23,29 = intermediate, and <23 = poor. Results., In patients who underwent CSP and HSP, sexual activity was good in 13% and 26%, intermediate in 33% and 21%, and poor in 54% and 53%, respectively; considering also five patients who no longer had sexual activity postoperatively. Nevertheless, the statistical analysis, performed based on the data obtained from the FSFI questionnaire, showed that there were no significant differences between the two groups of points in terms of total score,CSP 21.1 (1.2,33.5) vs. HSP 22.8 (3.6,34.5),and single domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) (P = not significant). Conclusions., Our data demonstrated no substantial differences regarding sexual activity in patients in which the uterus has been spared as opposed to those in whom it has been removed. Furthermore, in a small percentage of cases, surgery actually reduced regular sexual activity. Zucchi A, Costantini E, Mearini L, Fioretti F, Bini V, and Porena M. Female sexual dysfunction in urogenital prolapse surgery: Colposacropexy vs. hysterocolposacropexy. J Sex Med 2008;5:139,145. [source] The effect of continence surgery on urogenital prolapseBJU INTERNATIONAL, Issue 1 2004D. Robinson First page of article [source] | ||||||||||