Efficacy of Transurethral Vesical Deafferentation with Mid-Urethral Sling Operation for Female Mixed Urinary Incontinence: Preliminary Results.
OBJECTIVE
In female patients with mixed urinary incontinence (MUI), a mid-urethral sling operation (MUS) is an effective treatment for stress urinary incontinence (SUI), but urgency urinary incontinence (UUI) frequently persists. We developed a novel transurethral vesical deafferentation procedure and assessed its efficacy in these patients.


METHODS
From December 2009 to December 2012, 41 female patients with MUI were enrolled prospectively. After baseline evaluation including urodynamic study and symptom questionnaires (Overactive Bladder Symptom Score (OABSS) and International Consultation on Incontinence Questionnaire - Overactive Bladder [ICIQ-OAB]), patients in the study group underwent both the deafferentation procedure and MUS, and those in the control group underwent MUS alone. The outcome was assessed 3 months after the operation by subjective assessment of SUI and OABSS.


RESULTS
At 3 months, the treatment response rate of UUI was significantly higher in the study group than in the control group; UUI was improved in 80 and 57.1% of patients, respectively. SUI was cured in most patients. There were no serious complications, such as voiding symptom and urinary retention.


CONCLUSIONS
The transurethral vesical deafferentation procedure combined with MUS is effective for the treatment of MUI. The procedure is simple, safe and efficacious in treating urgency and UUI without affecting voiding function.
Department of Urology, Myongji Hospital, Goyang, Korea.
Sang Jin
SJ
Kim
Departmenet of Urology, Hanyang University College of Medicine, Seoul, Korea.
Jung Soo
JS
Park
Departmenet of Urology, Hanyang University College of Medicine, Seoul, Korea.
Kyoung Taek
KT
Lim
Departmenet of Urology, Hanyang University College of Medicine, Seoul, Korea.
Hong Sang
HS
Moon
Departmenet of Urology, Hanyang University College of Medicine, Seoul, Korea.
Yong Tae
YT
Kim
D000344:Afferent Pathways / Q000601:surgery; D000359:Aftercare; D005260:Female; D006801:Humans; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation / Q000601:surgery; D014549:Urinary Incontinence / Q000601:surgery*
deafferentation; mid-urethral sling; mixed incontinence