Skip to main content
Top
Published in: International Urogynecology Journal 8/2011

01-08-2011 | Original Article

Surgical treatment of mixed urinary incontinence: effect of anterior colpoplasty

Authors: Judith Lleberia, Josep Pubill, Montse Mestre, Emma Garcia, Maria Grimau, Eduardo Bataller

Published in: International Urogynecology Journal | Issue 8/2011

Login to get access

Abstract

Introduction and hypothesis

The aims of this study are to study the surgical outcomes in patients with stress-predominant mixed urinary incontinence (MUI) treated with tension-free vaginal tape, and to evaluate the effect of concomitant anterior colpoplasty.

Methods

A total of 134 women with MUI clinical and urodynamic were assessed at 6 months and annually (maximum 9 years) after surgery.

Results

As a whole, a complete healing of 49–51% at 3 years is observed, which hence could result in a tax drop of 36.8% at 5–9 years. Nevertheless, the rate of healing or improvement (subjective) is 73.7% at long term (5–9 years). There were no significant differences between the two techniques used: TVT vs TVT-Obturator. On the other hand, we have found significant differences between association of anterior colpoplasty and not (complete healing rate 34.6% vs 64.6%, p = 0.014), at 2 years of monitoring.

Conclusions

MUI with cystocele presents better surgical results for two components of incontinence, with its physiopathogenic implications.
Literature
1.
go back to reference Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 21:5–26CrossRef Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 21:5–26CrossRef
2.
go back to reference Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ (2001) How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 87:760–766PubMedCrossRef Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ (2001) How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 87:760–766PubMedCrossRef
3.
go back to reference Melville JL, Katon W, Delaney K, Newton K (2005) Urinary incontinence in US women. Arch Intern Med 165:537–542PubMedCrossRef Melville JL, Katon W, Delaney K, Newton K (2005) Urinary incontinence in US women. Arch Intern Med 165:537–542PubMedCrossRef
4.
go back to reference Hunskaar S, Lose G, Sykes D, Voss S (2004) The prevalence of urinary incontinence in women in four European countries. BJU Int 93:324–330PubMedCrossRef Hunskaar S, Lose G, Sykes D, Voss S (2004) The prevalence of urinary incontinence in women in four European countries. BJU Int 93:324–330PubMedCrossRef
5.
go back to reference Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Shaffer J et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300:1311–1316PubMedCrossRef Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Shaffer J et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300:1311–1316PubMedCrossRef
6.
go back to reference Catalan Health Service (2000) Butlletí d’informació terapèutica, volume 2 (February issue) Catalan Health Service (2000) Butlletí d’informació terapèutica, volume 2 (February issue)
7.
go back to reference Abrams P, Cardozo L, Khouny S, Wein A (2009) INCONTINENCE, 4th ed., Editions 21 Abrams P, Cardozo L, Khouny S, Wein A (2009) INCONTINENCE, 4th ed., Editions 21
8.
go back to reference Amaro JL, Gameiro MO, Kawano PR, Padovani CR (2006) Intravaginal electrical stimulation: a randomized, double-blind study on the treatment of mixed urinary incontinence. Acta Obstet Gynecol Scand 85:619–622PubMedCrossRef Amaro JL, Gameiro MO, Kawano PR, Padovani CR (2006) Intravaginal electrical stimulation: a randomized, double-blind study on the treatment of mixed urinary incontinence. Acta Obstet Gynecol Scand 85:619–622PubMedCrossRef
9.
go back to reference Ulmsten U, Henriksson L, Jonhson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7:81–86PubMedCrossRef Ulmsten U, Henriksson L, Jonhson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7:81–86PubMedCrossRef
10.
go back to reference De Leval J (2003) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44:724–730PubMedCrossRef De Leval J (2003) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44:724–730PubMedCrossRef
11.
go back to reference Daneshgari F, Kong W, Swartz M (2008) Complications of mid urethral slings: important outcomes for future clinical trials. J Urol 180:1890–1897PubMedCrossRef Daneshgari F, Kong W, Swartz M (2008) Complications of mid urethral slings: important outcomes for future clinical trials. J Urol 180:1890–1897PubMedCrossRef
12.
go back to reference Latthe PM, Singh P, Foon R, Toozs-Hobson P (2010) Two routes of transobturator tape procedure in stress urinary incontinence: a meta-analysis with direct and indirect comparison of randomized trials. BJU Int 106:68–76PubMedCrossRef Latthe PM, Singh P, Foon R, Toozs-Hobson P (2010) Two routes of transobturator tape procedure in stress urinary incontinence: a meta-analysis with direct and indirect comparison of randomized trials. BJU Int 106:68–76PubMedCrossRef
13.
go back to reference David-Montefiore E, Frobert JL, Grisard-Anaf M, Lienhart J, Bonnet K, Poncelet C et al (2006) Peri-operative complications and pain after the suburethral sling procedure for urinary stress incontinence: a French prospective randomized multicentre study comparing the retropubic and transobturator routes. Eur Urol 49:133–138PubMedCrossRef David-Montefiore E, Frobert JL, Grisard-Anaf M, Lienhart J, Bonnet K, Poncelet C et al (2006) Peri-operative complications and pain after the suburethral sling procedure for urinary stress incontinence: a French prospective randomized multicentre study comparing the retropubic and transobturator routes. Eur Urol 49:133–138PubMedCrossRef
14.
go back to reference Duckett JR, Tamilselvi A (2006) Effect of tension-free vaginal tape in women with a urodynamic diagnosis of idiopathic detrusor overactivity and stress incontinence. BJOG 113:30–33PubMed Duckett JR, Tamilselvi A (2006) Effect of tension-free vaginal tape in women with a urodynamic diagnosis of idiopathic detrusor overactivity and stress incontinence. BJOG 113:30–33PubMed
15.
go back to reference Kulseng-Hanssen S, Husby H, Schiotz HA (2007) Follow-up of TVT operations in 1113 women with urinary incontinence at 7 and 38 months. Int Urogynecol J Pelvic Floor Dysfunct 19:391–396PubMed Kulseng-Hanssen S, Husby H, Schiotz HA (2007) Follow-up of TVT operations in 1113 women with urinary incontinence at 7 and 38 months. Int Urogynecol J Pelvic Floor Dysfunct 19:391–396PubMed
16.
go back to reference Sinha D, Blackwell A, Moran PA (2008) Outcome measures after TVT for mixed urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:927–931PubMedCrossRef Sinha D, Blackwell A, Moran PA (2008) Outcome measures after TVT for mixed urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:927–931PubMedCrossRef
17.
go back to reference Abdel-Hady ES, Constantine G (2005) Outcome of the use of tension-free vaginal tape in women with mixed urinary incontinence, previous failed surgery, or low valsalva pressure. J Obstet Gynaecol Res 31:38–42CrossRef Abdel-Hady ES, Constantine G (2005) Outcome of the use of tension-free vaginal tape in women with mixed urinary incontinence, previous failed surgery, or low valsalva pressure. J Obstet Gynaecol Res 31:38–42CrossRef
18.
go back to reference Rezapour M, Ulmsten U (2001) Tension-free vaginal tape (TVT) in women with mixed urinary incontinence—a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct Suppl 2:S15–S18CrossRef Rezapour M, Ulmsten U (2001) Tension-free vaginal tape (TVT) in women with mixed urinary incontinence—a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct Suppl 2:S15–S18CrossRef
19.
go back to reference Digesu GA, Salvatore S, Chaliha C, Athanasiou S, Milani R, Khullar V (2007) Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse? Int Urogynecol J Pelvic Floor Dysfunct 18:1439–1443PubMedCrossRef Digesu GA, Salvatore S, Chaliha C, Athanasiou S, Milani R, Khullar V (2007) Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse? Int Urogynecol J Pelvic Floor Dysfunct 18:1439–1443PubMedCrossRef
20.
go back to reference de Boer TA, Salvatore S, Cardozo L, Chapple C, Kelleher C, van Kerrebroeck P et al (2010) Pelvic organ prolapse and overactive bladder. Neurourol Urodyn 29:30–39PubMedCrossRef de Boer TA, Salvatore S, Cardozo L, Chapple C, Kelleher C, van Kerrebroeck P et al (2010) Pelvic organ prolapse and overactive bladder. Neurourol Urodyn 29:30–39PubMedCrossRef
21.
go back to reference Crystle CD, Charme LS, Copeland WE (1971) Q-tip test in stress urinary incontinence. Obstet Gynecol 38:313–315PubMed Crystle CD, Charme LS, Copeland WE (1971) Q-tip test in stress urinary incontinence. Obstet Gynecol 38:313–315PubMed
22.
go back to reference Baden WF, Walker TA (1972) Genesis of the vaginal prolapse: a correlated classification of vaginal relaxation. Clin Obstet Gynecol 15(4):1048–1054PubMedCrossRef Baden WF, Walker TA (1972) Genesis of the vaginal prolapse: a correlated classification of vaginal relaxation. Clin Obstet Gynecol 15(4):1048–1054PubMedCrossRef
23.
go back to reference Debodinance P, Delporte P, Engrand JB, Boulongne M (2002) Tension-free vaginal tape (TVT) in the treatment of urinary stress incontinence: 3 years experience involving 256 operations. Eur J Obstet Gynecol Reprod Biol 105:49–58PubMedCrossRef Debodinance P, Delporte P, Engrand JB, Boulongne M (2002) Tension-free vaginal tape (TVT) in the treatment of urinary stress incontinence: 3 years experience involving 256 operations. Eur J Obstet Gynecol Reprod Biol 105:49–58PubMedCrossRef
24.
go back to reference Lee KS, Choo MS, Doo CK, Han DK, Lee YS, Kim JY et al (2008) The long term (5-years) objective TVT success rate does not depend on predictive factors at multivariate analysis a multicentre retrospective study. Eur Urol 53:176–183PubMedCrossRef Lee KS, Choo MS, Doo CK, Han DK, Lee YS, Kim JY et al (2008) The long term (5-years) objective TVT success rate does not depend on predictive factors at multivariate analysis a multicentre retrospective study. Eur Urol 53:176–183PubMedCrossRef
25.
go back to reference Holmgren C, Nilsson S, Lanner L, Hellberg D (2005) Long-term results with tension-free vaginal tape on mixed and stress urinary incontinence. Obstet Gynecol 106:38–43PubMedCrossRef Holmgren C, Nilsson S, Lanner L, Hellberg D (2005) Long-term results with tension-free vaginal tape on mixed and stress urinary incontinence. Obstet Gynecol 106:38–43PubMedCrossRef
26.
go back to reference Zullo MA, Plotti F, Calcagno M, Marullo E, Palaia I, Bellati et al (2001) One-year follow-up of tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: a prospective randomized trial. Eur Urol 51:1376–1384CrossRef Zullo MA, Plotti F, Calcagno M, Marullo E, Palaia I, Bellati et al (2001) One-year follow-up of tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: a prospective randomized trial. Eur Urol 51:1376–1384CrossRef
27.
go back to reference Celebi I, Güngördük K, Ark C, Akyol A (2009) Results of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence: a 5-year follow-up study. Arch Gynecol Obstet 279:463–467PubMedCrossRef Celebi I, Güngördük K, Ark C, Akyol A (2009) Results of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence: a 5-year follow-up study. Arch Gynecol Obstet 279:463–467PubMedCrossRef
28.
go back to reference Chin HY, Chiang CH, Lin KC, Wang CJ, Lee CL, Soong YK (2009) Prospective assessment of overactive bladder symptoms in women who have undergone transvaginal surgery for advanced vaginal wall prolapse: a preliminary report. J Obstet Gynaecol Res 35:732–737PubMedCrossRef Chin HY, Chiang CH, Lin KC, Wang CJ, Lee CL, Soong YK (2009) Prospective assessment of overactive bladder symptoms in women who have undergone transvaginal surgery for advanced vaginal wall prolapse: a preliminary report. J Obstet Gynaecol Res 35:732–737PubMedCrossRef
29.
go back to reference Abouassaly R, Steinberg JR, Lemieux M, Marois C, Gilchrist LI, Bourque JL et al (2004) Complications of tension-free vaginal tape surgery: a multi-institutional review. BJU Int 94:110–113PubMedCrossRef Abouassaly R, Steinberg JR, Lemieux M, Marois C, Gilchrist LI, Bourque JL et al (2004) Complications of tension-free vaginal tape surgery: a multi-institutional review. BJU Int 94:110–113PubMedCrossRef
30.
go back to reference Hinoul P, Ombelet WU, Burger MP, Roovers JP (2008) A prospective study to evaluate the anatomic and functional outcome of a transobturator mesh kit (Prolift Anterior) for symptomatic cystocele repair. J Minim Invasive Gynecol 15:615–620PubMedCrossRef Hinoul P, Ombelet WU, Burger MP, Roovers JP (2008) A prospective study to evaluate the anatomic and functional outcome of a transobturator mesh kit (Prolift Anterior) for symptomatic cystocele repair. J Minim Invasive Gynecol 15:615–620PubMedCrossRef
Metadata
Title
Surgical treatment of mixed urinary incontinence: effect of anterior colpoplasty
Authors
Judith Lleberia
Josep Pubill
Montse Mestre
Emma Garcia
Maria Grimau
Eduardo Bataller
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 8/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1351-6

Other articles of this Issue 8/2011

International Urogynecology Journal 8/2011 Go to the issue