title: Simultaneous self-created transobturator tape and laparoscopic extraperitoneal vaginal support in patients with stress urinary incontinence and prolapse of the anterior and apical vaginal compartments.
abstract: OBJECTIVE
  Stress urinary incontinence (SUI) is frequently associated with prolapse of the apical and anterior vaginal compartments. The standard treatment of SUI is transobturator tape (TOT). The usual treatment of prolapse (anterior colporrhaphy) has a high recurrence rate. The aim of this study is to evaluate the results of the treatment of SUI and concomitant anterior and apical prolapse with self-created transobturator tape and simultaneous laparoscopic anterior and apical support.
  
  
  METHODS
  A total of 36 patients with SUI and prolapse of the anterior and apical compartments were underwent operations. The mean follow-up was 18 months. Self-created transobturator tape and laparoscopical support of the anterior and apical compartment prolapse were performed in all patients. The most important symptoms of prolapse and incontinence, the anatomical outcome, and complications were evaluated before and after the surgery.
  
  
  RESULTS
  Treatment of incontinence and anterior and apical prolapse was successful in 33/36 (91.7%), 30/36 (83.3%) and 31/36 (86.1%) patients, respectively (p<0.0001). There is a significant reduction of vaginal bulging and pelvic pressure (p<0.0001). Frequency and urgency were significantly reduced (p<0.0007 and p<0.03 respectively). There was no significant deterioration of the posterior compartment. The most important complications were bladder perforation in 2/36 (5.5%) patients and temporary urinary retention in 3/36 (8.3%) patients (Clavien-Dindo grade 3).
  
  
  CONCLUSIONS
  Simultaneous laparoscopic anterior and lateral extraperitoneal support and transobturator tape are effective in the treatment of patients with both conditions.
authors: Department of Urology, Clinical Center Nis, School of Medicine, Nis, Serbia. Electronic address: ivanig@live.com.
authors: Ivan
authors: I
authors: Ignjatovic
authors: Department of Urology, Clinical Center Nis, School of Medicine, Nis, Serbia.
authors: Dragoslav
authors: D
authors: Basic
authors: Department of Urology, Clinical Center Nis, School of Medicine, Nis, Serbia.
authors: Milan
authors: M
authors: Potic
authors: Department of Urology, Clinical Center Nis, School of Medicine, Nis, Serbia.
authors: Ljubomir
authors: L
authors: Dinic
authors: Department of Urology, Clinical Center Nis, School of Medicine, Nis, Serbia.
authors: Jablan
authors: J
authors: Stankovic
authors: Center for Anesthesia, Clinical Center Nis, School of Medicine, Nis, Serbia.
authors: Svetlana
authors: S
authors: Pavlovic
authors: Center for Anesthesia, Clinical Center Nis, School of Medicine, Nis, Serbia.
authors: Vladimir
authors: V
authors: Milic
authors: Department of Urology, Clinical Center Nis, School of Medicine, Nis, Serbia.
authors: Aleksandar
authors: A
authors: Skakic
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000601:surgery
keywords: Laparoscopy; Prolapse; Stress urinary incontinence; Transobturator tape