The value of cystoscopy and bladder biopsy taken at the time of tension-free vaginal tape insertion.
The primary aim of this study was to determine if a cystoscopy performed at the time of a tension-free vaginal tape (TVT) insertion is useful in finding unexpected pathology. A secondary outcome measure was to assess whether a bladder biopsy and cystoscopy performed during the TVT operation provide useful information about the outcome of surgery. The findings in 100 consecutive women were reviewed. A total of 42 women demonstrated mixed detrusor overactivity (DO) and urodynamic stress incontinence (USI); 32 women had abnormal biopsies. Women with DO were no more likely to have abnormal bladder biopsies than women without DO (p > 0.05). An abnormal bladder biopsy or cystoscopy failed to predict postoperative irritable symptoms (p > 0.05). The presence of preoperative DO correctly predicted postoperative irritable symptoms (p < 0.01). Cystoscopic abnormalities were noted in 14 women including one carcinoma, and one case of dysplasia was discovered on biopsy. In five women, the cystoscopy showed a bladder perforation. Cystoscopy should be performed in all women undergoing continence procedures.
Duckett
J
J
Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent, UK. jraduckett@hotmail.com
Aggarwal
I
I
Basu
M
M
Vella
M
M
Patil
A
A
D001706:Biopsy; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D053825:Suburethral Slings; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000473:pathology; D014550:Urinary Incontinence, Stress / Q000473:pathology / Q000601:surgery*