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Clinical study on concomitant surgery for stress urinary incontinence and pelvic organ prolapse

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF SURGERY
Issue:
20
DOI:
10.3321/j.issn:0529-5815.2008.20.005
Key Word:
子宫脱垂;直肠脱垂;压力性尿失禁;外科手术;Uherine prolapse;Ractal prolapse;Urinary incontinence,stress;Surgical procedure,operative

Abstract: Objective To discuss indications and therapeutic effects of concomitant surgery for stress urinary incontinence(SUI)and pelvic organ prolapse(POP)through a retrospective clinical review.Method A retrospective review ofthe data of 16 women undergoing concomitant surgery for SUI and POP WaS available for analysis.In these cases.12 patients presented with SUI symptoms associated with medemte or Severe anterior vaginal wall prolapse;4 patients had moderate or severe uterine prolapse associated with dySUXia.All cases were confirmed to have type II stress urinary incontinence by preoperative physical examination,uredynamic study and cystography.The surgical procedures for pelvic floor repair included the placement of Gynemesh mesh impant.anterior or total Prolift mesh implant.The tension-free vaginal tape (TVT)or transvaginal tension free vaginal tape-obturator(TVT-O)was used for the anti-incontinence procedure.During the concurrent surgical procedures,pelvic floor repair was performed first.Results Followel up from 6 to 30 months.all cases got satisfactory results.After the procedure,the patients achieved complere continence without occurrence of dysuria or recurrence of POP.Conclusions Stress inconfinence and pelvic organ prolapse share common pathophysiologic etiologies and often coexist with one another. In SUI patients with symptomatic or mederate to severe POP,concurrent POP surgery shoed be performed actively at the time ofincontinence surgery to prevent POP exacerbation and the occurrence ofdysuria;while in padents with sole POP,occult SUI should be eonsidered,and concomitant prophylactic incontinence measures should be taken at the time of POP rear to prevent the postoperative unmasking of SUI.

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