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Early outcomes of mid-urethral slings for female stress urinary incontinence stratified by valsalva leak point pressure. Neurourol Urodyn 2006;25(7):685-8

Date

07/04/2006

Pubmed ID

16817185

DOI

10.1002/nau.20286

Scopus ID

2-s2.0-33749166853 (requires institutional sign-in at Scopus site)   71 Citations

Abstract

AIMS: To assess the early results of mid-urethral slings placed via the transobturator approach (TVT-O) for stress urinary incontinence (SUI) in women with high (>60 cm H(2)O) and low (<or=60 cm H(2)O) valsalva leak point pressure (VLPP).

MATERIALS AND METHODS: Forty-three women with urodynamically proven SUI underwent TVT-O. Patients were divided into either high (>60 cm H(2)O) or low (<or=60 cm H(2)O) VLPP categories based on preoperative urodynamic studies. Patient outcomes were assessed based on degree of postoperative SUI as either dry (no pads, no SUI), or wet (any leakage). Follow-up visits were at 1, 6, 12, and 24 weeks.

RESULTS: Overall, 65% (28/43) women were cured following TVT-O for SUI. When stratified based on preoperative VLPP, 77% (24/31) of patients with VLPP greater than 60 were cured while only 25% (3/12) of patients with VLPP less than or equal to 60 were cured. No intraoperative complications were noted. The odds of continued SUI following TVT-O were 12 times greater for women with VLPP <or=60 compared to those with VLPP >60.

CONCLUSIONS: With limited follow up, TVT-O appears to be a safe and effective surgical treatment for female SUI producing excellent results in patients with VLPP >60 cm/H(2)0. Patients with low VLPP may consider conventional, retropubic mid-urethral slings or other procedures as treatment for SUI.

Author List

O'Connor RC, Nanigian DK, Lyon MB, Ellison LM, Bales GT, Stone AR

Author

Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Cohort Studies
Female
Humans
Middle Aged
Pressure
Retrospective Studies
Treatment Outcome
Urethra
Urinary Incontinence, Stress
Urodynamics
Urologic Surgical Procedures
Valsalva Maneuver