Tension-free vaginal tape efficacy in relation to collagen quantity of pubocervical fascia.
OBJECTIVE
To investigate whether the quantity of collagen types I and III in the pubocervical fascia of women with genuine stress incontinence (GSI) affects the efficacy of the tension-free vaginal tape (TVT) procedure.


METHODS
Sixty-three patients participated in the study and were divided in 2 groups as follows: 37 patients with GSI and pelvic organ prolapse stage I (group 1), and 26 patients with pelvic organ prolapse stage I but not GSI (control group). Urodynamic studies confirmed the diagnosis of GSI. Biopsies were obtained during surgery from the pubocervical fascia.


RESULTS
The quantity of collagen types I and III was statistically significantly reduced in patients with GSI compared to the control group. The efficacy of the TVT procedure in patients with a significant reduction in collagen type I was an 82.1% cure. In patients with a significant reduction in collagen type III, the TVT efficacy was an 85.1% cure. The efficacy of the TVT procedure was not statistically significantly different between patients with GSI and a significant reduction in collagen types I and III, and patients with no reduction in collagen types I and III.


CONCLUSIONS
The significantly reduced quantity of collagen types I and III in the pubocervical fascia of women with GSI does not affect the efficacy of the TVT procedure at an average of 25 months of follow-up.
Bakas
P
P
2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, Urogynecology Unit, University of Athens, Athens, Greece. eurotas@ath.forthnet.gr
Liapis
A
A
Salamalekis
E
E
Pafiti
A
A
Creatsas
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri; D003094:Collagen / Q000032:analysis*; D024042:Collagen Type I / Q000032:analysis; D024061:Collagen Type III / Q000032:analysis; D005205:Fascia / Q000737:chemistry*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000378:metabolism / Q000601:surgery*; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000601:surgery*
D024042:Collagen Type I; D024061:Collagen Type III; D003094:Collagen