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International Urogynecology Journal

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01-03-2019 | Original Article

Outcome of rolled fortified vaginal flap operation on female patients with intrinsic sphincteric deficiency: 2-year follow-up

Authors: Mohamed Shoukry, Mostafa Elmissiry, Mohamed Hassouna, Haitham Abdelmoteleb

Published in: International Urogynecology Journal | Issue 3/2019

Abstract

Introduction and hypothesis

We evaluate the 2-year outcome of the rolled fortified vaginal flap (RFVF) operation for the treatment of stress urinary incontinence (SUI) due to intrinsic sphincteric deficiency (ISD).

Methods

A prospective study of 20 women suffering from SUI due to ISD was conducted. All patients were subjected to history-taking, clinical examination, cough stress test, and urodynamics. Symptom severity and quality of life (QoL) were assessed using the Arabic version of the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF). All studied women were followed up for 24 months to detect success rate, any postoperative complications, and reveal changes in the quality of life.

Results

Mean age was 53 ± 8 years. Preoperative Valsalva leak point pressure was 50.1 ± 11.3 cmH₂O. After a follow-up period of 24 months, only 2 patients (10%) showed mild stress incontinence with mean VLPP 80± 3 cm H₂O. Postoperative mean maximum flow rate (Q-max) and mean Pdet-Qmax showed no significant difference from the preoperative results (P = 0.115 and 0.187 respectively). The quality of life domain of the ICIQ-UI-SF decreased significantly from 73.5 ± 12.1% (preoperatively) to 2.6 ± 8.1% (after a 1-year follow-up), P < 0.001 and then showed a slight increase to 4.5 ± 10.6 at 24 months’ follow-up.

Conclusion

The RFVF operation has a success rate of 90% after a 24-month follow-up. It significantly improved the quality of life of women with SUI due to ISD.

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Thom D. Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc. 1998;46(4):473–80.CrossRefPubMed

Hannestad YS, Rortveit G, Sandvik H, Hunskaar S. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of incontinence in the county of Nord-Trøndelag. J Clin Epidemiol. 2000;53(11):1150–7.CrossRefPubMed

Ward KL, Hilton P. A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: two-year follow-up. Am J Obstet Gynecol. 2004;190(2):324–31.CrossRefPubMed

Wallner LP, Porten S, Meenan RT, O’Keefe Rosetti MC, Calhoun EA, Sarma AV, et al. Prevalence and severity of undiagnosed urinary incontinence in women. Am J Med. 2009;122(11):1037–42.CrossRefPubMedPubMedCentral

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the international continence society. Urology. 2003;61(1):37–49.CrossRefPubMed

Rawlings T, Zimmern PE. Economic analyses of stress urinary incontinence surgical procedures in women. Neurourol Urodyn. 2016;35(8):1040–5.CrossRefPubMed

McGuire EJ, Lytton B, Kohorn EI, Pepe V. The value of urodynamic testing in stress urinary incontinence. J Urol. 1980;124(2):256–8.CrossRefPubMed

Wang W, Zhu L, Lang J. Transobturator tape procedure versus tension-free vaginal tape for treatment of stress urinary incontinence. Int J Gynaecol Obstet. 2009;104(2):113–6.CrossRefPubMed

Wilson TS, Lemack GE, Zimmern PE. Management of intrinsic sphincteric deficiency in women. J Urol. 2003;169(5):1662–9.CrossRefPubMed

10.

Vayleux B, Rigaud J, Luyckx F, Karam G, Le Normand L. Female urinary incontinence and artificial urinary sphincter: study of efficacy and risk factors for failure and complications. Eur Urol. 2011;59(6):1048–53.CrossRefPubMed

11.

Hashim H, Avery K, Mourad MS, Chamssuddin A, Ghoniem G, Abrams P. The Arabic ICIQ-UI SF: an alternative language version of the English ICIQ-UI SF. Neurourol Urodyn. 2006;25(3):277–82.CrossRefPubMed

12.

Abrams P, Avery K, Gardener N, Donovan J. The international consultation on incontinence modular questionnaire: www.iciq.net. J Urol. 2006;175(3 Pt 1):1063–6. discussion 1066CrossRefPubMed

13.

Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn. 2000;19(5):553–64.CrossRefPubMed

14.

Shoukry M, Hassouna M, AbdEl-Kerim A, et al. Rolled vaginal wall flap for the treatment of stress urinary incontinence. African J Urol. 2011;17:1–5.CrossRef

15.

Kuuva N, Nilsson CG. Long-term results of the tension-free vaginal tape operation in an unselected group of 129 stress incontinent women. Acta Obstet Gynecol Scand. 2006;85(4):482–7.CrossRefPubMed

16.

Doo CK, Hong B, Chung BJ, Kim JY, Jung HC, Lee K-SS, et al. Five-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence. Eur Urol. 2006;50(2):333–8.CrossRefPubMed

17.

Paick JS, Ku JH, Shin JW, Son H, Oh SJ, Kim SW. Tension-free vaginal tape procedure for urinary incontinence with low Valsalva leak point pressure. J Urol. 2004;172(4 Pt 1):1370–3.CrossRefPubMed

18.

Bullock T, Ghoniem G, Klutke C, Staskin D. Advances in female stress urinary incontinence: mid-urethral slings. BJU Int. 2006;98(S1):32–40.CrossRefPubMed

19.

Phé V, Benadiba S, Rouprêt M, Granger B, Richard F, Chartier-Kastler E. Long-term functional outcomes after artificial urinary sphincter implantation in women with stress urinary incontinence. BJU Int. 2014;113(6):961–7.CrossRefPubMed

20.

Klovning A, Avery K, Sandvik H, Hunskaar S. Comparison of two questionnaires for assessing the severity of urinary incontinence: the ICIQ-UI SF versus the incontinence severity index. Neurourol Urodyn. 2009;28(5):411–5.CrossRefPubMed

21.

Morgan TO, Westney OL, McGuire EJ. Pubovaginal sling: 4-year outcome analysis and quality of life assessment. J Urol. 2000;163(6):1845–8.CrossRefPubMed

22.

Holmgren C, Hellberg D, Lanner L, Nilsson S. Quality of life after tension-free vaginal tape surgery for female stress incontinence. Scand J Urol Nephrol. 2006;40(2):131–7.CrossRefPubMed

Title: Outcome of rolled fortified vaginal flap operation on female patients with intrinsic sphincteric deficiency: 2-year follow-up
Authors: Mohamed Shoukry
Mostafa Elmissiry
Mohamed Hassouna
Haitham Abdelmoteleb
Publication date: 01-03-2019
Publisher: Springer International Publishing
Published in: International Urogynecology Journal / Issue 3/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-018-3621-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcome of rolled fortified vaginal flap operation on female patients with intrinsic sphincteric deficiency: 2-year follow-up

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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