Stress urinary incontinence in patients treated for cervical cancer: is TVT-Secur a valuable treatment option?
We present two patients with bothersome stress urinary incontinence (SUI) following radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer. One patient underwent adjuvant radiotherapy. We selected, after extensive counseling, TVT-Secur in these two patients as we aimed to avoid the pelvic cavity, expecting altered anatomy due to major pelvic surgery, and counting on low risk of developing bladder retention, given results of a case series. Both patients were continent post-operatively. One patient presented with a small tape erosion that was successfully corrected using local analgesics. The other patient developed urgency symptoms that disappeared after treatment with solifenacine. Both patients had detrusor hypo-activity at pre-operative urodynamics, but no bladder retention occurred following surgery. In patients with a history of radical hysterectomy who present with SUI, we would advise to counsel that satisfying results can be expected of TVT-Secur, although it is likely that additional care after surgery is needed.
Hazewinkel
Menke H
MH
Department of Gynaecology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands. m.h.hazewinkel@amc.uva.nl
Schilthuis
Marten S
MS
Roovers
Jan-Paul
JP