Anterior intravaginal slingplasty tunneller device for stress incontinence and posterior intravaginal slingplasty for apical vault prolapse: a 2-year prospective multicenter study.
OBJECTIVE
The purpose of this study was to report the outcome for (1) anterior intravaginal slingplasty in the treatment of urodynamic stress incontinence and (2) posterior intravaginal slingplasty for apical prolapse (> or = stage II).


METHODS
This was a 2-year prospective multicenter study: patients, 430; anterior intravaginal slingplasty, 144; posterior intravaginal slingplasty, 164; both procedures, 122 (552 tapes total). At 6 and 12 months, the results of the Pelvic Floor Impact Questionnaire, cough stress test, and Pelvic Organ Prolapse Quantitation were assessed. Statistical analyses used paired t-tests.


RESULTS
Of the women in the study, 95% (42 women) had a negative cough stress test result through 12 months (n = 44 women), and 96% (127 women) had a negative cough stress test result at 6 months (n = 132). At 6 months, apical support was optimal in 95.3% (143/150 women) and was satisfactory in 2.7% (4/150 women) and at 12 months, 98.1% (52/53 women), 1.9% (1/53 women). Seventeen of 430 patients (4.0%) had vaginal mesh extrusion. Pelvic Floor Impact Questionnaire scores significantly improved (P < .0001).


CONCLUSIONS
Anterior intravaginal slingplasty and posterior intravaginal slingplasty are safe and effective when performed with other procedures. For anterior intravaginal slingplasty, the rates of perforation and retention are low, but early extrusions are seen. Patients showed improvements in the Pelvic Floor Impact Questionnaire, regardless of extrusion.
Vardy
Michael D
MD
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. Michael.Vardy@mssm.edu
Brodman
Michael
M
Olivera
Cedric K
CK
Zhou
Huan-Sue
HS
Flisser
Adam J
AJ
Bercik
Richard S
RS
D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013519:Urogenital Surgical Procedures; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*