title: LeFort colpocleisis and stress incontinence: weighing the risk of voiding dysfunction with sling placement.
abstract: OBJECTIVE
  This study aims to evaluate clinical outcomes of concomitant suburethral sling with LeFort colpocleisis including its effect on postoperative voiding.
  
  
  METHODS
  We performed a retrospective review of all LeFort colpocleisis procedures from our institution. We reviewed demographics, symptoms of stress urinary incontinence, incontinent events/day, pads usage/day, urodynamic parameters, and presence of voiding dysfunction.
  
  
  RESULTS
  Two hundred ten patients underwent colpocleisis during the study period. Mean age was 82.2 ± 4.9 and median follow-up was 22 weeks (2-169). Preoperatively, 73 (35%) complained of stress urinary incontinence (SUI) symptoms, and an additional 105 (50%) were diagnosed with occult SUI. One hundred sixty-one (77%) patients underwent concurrent suburethral sling. Overall, sling placement resulted in a 92.5% subjective stress continent rate. Fifty-six patients presented with voiding dysfunction (VD). Postoperatively, VD resolved in 91%. De novo VD occurred in two patients (1.9%) and one (0.6%) required sling revision.
  
  
  CONCLUSIONS
  Sling placement at time of colpocleisis is associated with high continence rates with minimal risk of postoperative voiding dysfunction.
authors.affiliation: Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
authors.forename: Aimee L
authors.initials: AL
authors.lastname: Smith
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Karp
authors.forename: Roger
authors.initials: R
authors.lastname: Lefevre
authors.forename: Vivian C
authors.initials: VC
authors.lastname: Aguilar
authors.forename: G Willy
authors.initials: GW
authors.lastname: Davila
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D014621:Vagina / Q000601:surgery*