Treatment Results Using Pubovaginal Slings in Patients With Large Cystoceles and Stress Incontinence

Abstract

No AccessJournal of UrologyClinical Urology: Original Articles1 Aug 1997Treatment Results Using Pubovaginal Slings in Patients With Large Cystoceles and Stress Incontinence Cindy A. Cross, R. Duane Cespedes, and Edward J. McGuire Cindy A. CrossCindy A. Cross More articles by this author , R. Duane CespedesR. Duane Cespedes More articles by this author , and Edward J. McGuireEdward J. McGuire More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64495-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the efficacy of performing a pubovaginal sling concurrently with a formal cystocele repair in patients with grade III to IV cystoceles. Materials and Methods: We studied 42 women with grade III to IV cystoceles diagnosed by physical examination and video urodynamics. Of the patients 9 (22%) had intrinsic sphincter deficiency diagnosed by an abdominal leak point pressure of less the 60 cm. water, and 24 (57%) had type II stress incontinence with urethral hypermobility and an abdominal leak point pressure greater than 90 cm. water. A pubovaginal sling and anterior colporrhaphy were performed and, if indicated, other vaginal procedures were done at that time. Results: A total of 36 patients (86%) was available for postoperative pelvic examinations performed at 3-month intervals, for a mean followup of 20.4 months (range 12 to 39). Only 3 patients had symptomatic grade III cystoceles and 2 had enteroceles. Two patients required collagen injections and 2 underwent a repeat pubovaginal sling. Therefore, all patients were continent at the time of followup. Conclusions: This study confirms that in patients with large cystoceles and stress urinary incontinence a pubovaginal sling and anterior colporrhaphy effectively treat the incontinence and reduce the cystocele. In addition, the fascial sling appears to provide additional support to the bladder base, improving the durability of the anterior colporrhaphy. References 1 : The effect of uterovaginal prolapse on urethral pressure dynamics.. Amer. J. Obst. Gynec.1983; 146: 901. Google Scholar 2 : Fundamentals, symptoms, and classification. In: Surgical Repair of Vaginal Defects. Edited by . Philadelphia: J.B. Lippincott Co.1992: 9. Google Scholar 3 : Clinical assessment of urethral sphincter function.. J. Urol.1993; 150: 1452. Abstract, Google Scholar 4 : Surgical treatment of intrinsic urethral dysfunction, Slings.. Urol. Clin. N. Amer.1995; 22: 657. Google Scholar 5 : Bilateral attachment of the vaginal cuff to iliococcygeus fascia: an effective method of cuff suspension.. Amer. J. Obst. 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Google Scholar Departments of Obstetrics, Gynecology and Reproductive Medicine, and Urology, University of Texas Medical School at Houston, Houston and Department of Urology, Wilford Hall Medical Center, Lackland Air Force Base, Texas.The opinions contained herein are those of the authors and are not to be construed as reflecting the views of the Air Force or the Department of Defense.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKOBASHI K, LEACH G, CHON J and GOVIER F (2018) Continued Multicenter Followup of Cadaveric Prolapse Repair With Sling.Journal of Urology, VOL. 168, NO. 5, (2063-2068), Online publication date: 1-Nov-2002.BRADY C, AHMED I, DRUMM J and FLOOD H (2018) A PROSPECTIVE EVALUATION OF THE EFFICIENCY OF EARLY POSTOPERATIVE BLADDER EMPTYING AFTER THE STAMEY PROCEDURE OR PUBOVAGINAL SLING FOR STRESS URINARY INCONTINENCEJournal of Urology, VOL. 165, NO. 5, (1601-1604), Online publication date: 1-May-2001.KUO H (2018) COMPARISON OF VIDEO URODYNAMIC RESULTS AFTER THE PUBOVAGINAL SLING PROCEDURE USING RECTUS FASCIA AND POLYPROPYLENE MESH FOR STRESS URINARY INCONTINENCEJournal of Urology, VOL. 165, NO. 1, (163-168), Online publication date: 1-Jan-2001.KOBASHI K and LEACH G (2018) PELVIC PROLAPSEJournal of Urology, VOL. 164, NO. 6, (1879-1890), Online publication date: 1-Dec-2000.KAPLAN S, TE A, YOUNG G, ANDRADE A, CABELIN M and IKEGUCHI E (2018) PROSPECTIVE ANALYSIS OF 373 CONSECUTIVE WOMEN WITH STRESS URINARY INCONTINENCE TREATED WITH A VAGINAL WALL SLING: THE COLUMBIA-CORNELL UNIVERSITY EXPERIENCEJournal of Urology, VOL. 164, NO. 5, (1623-1627), Online publication date: 1-Nov-2000.CHAIKIN D, GROUTZ A and BLAIVAS J (2018) PREDICTING THE NEED FOR ANTI-INCONTINENCE SURGERY IN CONTINENT WOMEN UNDERGOING REPAIR OF SEVERE UROGENITAL PROLAPSEJournal of Urology, VOL. 163, NO. 2, (531-534), Online publication date: 1-Feb-2000.ROMANZI L, CHAIKIN D and BLAIVAS J (2018) THE EFFECT OF GENITAL PROLAPSE ON VOIDINGJournal of Urology, VOL. 161, NO. 2, (581-586), Online publication date: 1-Feb-1999.SAFIR M, GOUSSE A, ROVNER E, GINSBERG D and RAZ S (2018) 4-DEFECT REPAIR OF GRADE 4 CYSTOCELEJournal of Urology, VOL. 161, NO. 2, (587-594), Online publication date: 1-Feb-1999. Volume 158Issue 2August 1997Page: 431-434 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Cindy A. Cross More articles by this author R. Duane Cespedes More articles by this author Edward J. McGuire More articles by this author Expand All Advertisement PDF downloadLoading ...