[Clinical study on concomitant surgery for stress urinary incontinence and pelvic organ prolapse].
OBJECTIVE
To discuss indications and therapeutic effects of concomitant surgery for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) through a retrospective clinical review.


METHODS
A retrospective review of the data of 16 women undergoing concomitant surgery for SUI and POP was available for analysis. In these cases, 12 patients presented with SUI symptoms associated with moderate or severe anterior vaginal wall prolapse; 4 patients had moderate or severe uterine prolapse associated with dysuria. All cases were confirmed to have type II stress urinary incontinence by preoperative physical examination, urodynamic study and cystography. The surgical procedures for pelvic floor repair included the placement of Gynemesh mesh implant, anterior or total Prolift mesh implant. The tension-free vaginal tape (TVT) or transvaginal tension free vaginal tape-obturator (TVT-O) was used for the anti-incontinence procedure. During the concurrent surgical procedures, pelvic floor repair was performed first.


RESULTS
Followed up from 6 to 30 months, all cases got satisfactory results. After the procedure, the patients achieved complete continence without occurrence of dysuria or recurrence of POP.


CONCLUSIONS
Stress incontinence and pelvic organ prolapse share common pathophysiologic etiologies and often coexist with one another. In SUI patients with symptomatic or moderate to severe POP, concurrent POP surgery should be performed actively at the time of incontinence surgery to prevent POP exacerbation and the occurrence of dysuria; while in patients with sole POP, occult SUI should be considered, and concomitant prophylactic incontinence measures should be taken at the time of POP repair to prevent the postoperative unmasking of SUI.
YUAN
Zheng-yong
ZY
Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.
DAI
Yi
Y
CHEN
Yan
Y
WEI
Qiang
Q
SHEN
Hong
H
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D012189:Retrospective Studies; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D014782:Visceral Prolapse / Q000150:complications / Q000601:surgery*