title: A randomized comparison of tension-free vaginal tape and endopelvic fascia plication in women with genital prolapse and occult stress urinary incontinence.
abstract: OBJECTIVE
  The purpose of this study was to compare 2 anti-incontinence procedures in women who had severe genital prolapse and potential stress incontinence.
  
  
  METHODS
  In addition to vaginal reconstructive surgery, 50 patients with stage II or higher anterior defect and a positive stress test result with prolapse reduction received either tension-free vaginal tape or plication of the endopelvic fascia. Preoperative evaluation included history, physical examination, stress test, and urodynamic assessment. Data were analyzed with the Student t test, the Fisher's exact test, and the Wilcoxon signed-rank test.
  
  
  RESULTS
  The median follow-up time was similar for both groups, 26 and 24 months. Subjective (96% vs 64%; P=.01) and objective (92% vs 56%; P<.01) continence rates were higher after the tension-free vaginal tape procedure. Time for the resumption of spontaneous voiding, rates of urinary retention, or de novo urge incontinence were similar in the 2 groups.
  
  
  CONCLUSIONS
  Tension-free vaginal tape can be recommended for patients with prolapse and occult stress incontinence.
authors.affiliation: Department of Obstetrics and Gynecology, Urogynecology Unit, University of Milan, Milano, Italy. m.meschia@libero.it
authors.forename: Michele
authors.initials: M
authors.lastname: Meschia
authors.forename: Paola
authors.initials: P
authors.lastname: Pifarotti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Spennacchio
authors.forename: Arturo
authors.initials: A
authors.lastname: Buonaguidi
authors.forename: Umberto
authors.initials: U
authors.lastname: Gattei
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
mesh_terms: D000368:Aged; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010388:Pelvis; D013526:Surgical Mesh; D014014:Tissue Adhesives; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D014563:Urodynamics; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*
chemical_list: D014014:Tissue Adhesives