title: Ineffectiveness of associating a suburethral tape to a transobturator mesh for cystocele correction on concomitant stress urinary incontinence.
abstract: OBJECTIVE
  To evaluate the effect of a transobturator subvesical mesh for cystocele on concomitant stress urinary incontinence (SUI). Genital and urinary prolapse surgery presents difficulties, particularly regarding cure of SUI. Advances in vaginal prosthetic surgery could correct these difficulties.
  
  
  METHODS
  Between July 2003 and October 2007, a total of 74 patients with a minimum stage 2 anterior prolapse with concomitant SUI were operated on, using a porcine collagen-coated large-pore-size monofilament polypropylene mesh with 2 transobturator expansions, but without an additional procedure for SUI. All patients had a physical examination and a subjective symptoms assessment using a questionnaire in the preoperative period and again 6 weeks, 6 months, and then each year after surgery. The pelvic organ prolapse quantification system was used for anatomic results. For SUI, Ingelman-Sundberg classification and cough test were used. Loss of urine was measured by a 1-hour pad test. Functional results were evaluated by visual analog scale, pelvic floor distress inventory, and pelvic floor impact questionnaire.
  
  
  RESULTS
  Median follow-up was 36 months (range 12-51). Seventy-two women (97%) were cured of their prolapse. A total of 53 women (72%) were cured of their SUI and 11 (15%) were improved. Pad test, visual analog scale, pelvic floor distress inventory, and pelvic floor impact questionnaire all showed improvement (P <.05). Prolonged bladder catheterization was not required. Complications consisted of 1 hematoma requiring blood transfusion and 5 vaginal extrusions (6%).
  
  
  CONCLUSIONS
  Transvaginal mono prosthesis for the simultaneous correction of prolapse and SUI represents an effective treatment without the risk of prolonged urinary retention.
authors: Department of Gynaecology and Obstetrics, Rouen University Hospital, University of Rouen, Rouen, France. Fabrice.Sergent@chu-rouen.fr
authors: Fabrice
authors: F
authors: Sergent
authors: Gaëlle
authors: G
authors: Gay-Crosier
authors: Violène
authors: V
authors: Bisson
authors: Benoît
authors: B
authors: Resch
authors: Eric
authors: E
authors: Verspyck
authors: Loïc
authors: L
authors: Marpeau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D052858:Cystocele / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh; D014550:Urinary Incontinence, Stress / Q000150:complications*