Urodynamic assessment of anterior vaginal wall surgery: a randomized comparison between colporraphy and transvaginal mesh.
OBJECTIVE
To investigate the urodynamic effects of anterior vaginal wall prolapse surgery using either trocar guided transvaginal mesh or colporraphy.


METHODS
A prospective, randomized multicenter trial enrolling 50 patients: 27 underwent anterior colporrhaphy and 23 anterior trocar guided transvaginal mesh. Urodynamic assessment was performed pre- and two months postoperatively.


RESULTS
De novo stress urinary incontinence was significantly more common after trocar guided transvaginal mesh surgery compared to colporraphy. In comparison to baseline urodynamics, transvaginal mesh surgery resulted in a significant decrease in maximal urethral closing pressures (MUCP) whereas conventional anterior colporraphy had no significant effect on urodynamic parameters.


CONCLUSIONS
Trocar guided transvaginal mesh of anterior vaginal wall prolapse results in a lowering of MUCPs and increases the risk for de novo stress urinary incontinence compared to colporraphy.
Ek
Marion
M
Division of Obstetrics and Gynaecology, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. marion.ek@sodersjukhuset.se
Tegerstedt
Gunilla
G
Falconer
Christian
C
Kjaeldgaard
Anders
A
Rezapour
Masoumeh
M
Rudnicki
Martin
M
Altman
Daniel
D
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011897:Random Allocation; D053825:Suburethral Slings; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D014563:Urodynamics; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000601:surgery*