Center-by-center results of a multicenter prospective trial to determine the inter-observer correlation of the simplified POP-Q in describing pelvic organ prolapse

Section: Methodsmentioning

confidence: 99%

Urethral funneling visualized during pelvic floor sonography — analysis of occurrence among urogynecological patients

Wlaźlak¹,

Kluz²,

Surkont³

et al. 2018

“…Pelvic organ prolapse (POP) was classified in accordance with POP-Q system [21][22][23][24][25]. SUI was confirmed by a cough test [26].…”

Section: Methodsmentioning

confidence: 99%

Adjustable single incision sling Ajust — the effects of first operations controlled by pelvic floor sonography

Kluz¹,

Wlaźlak²,

Wróbel³

et al. 2017

Objective: The aim of this study is to evaluate using PFS-TV the mid-term results of our first operative experience with implanting a single incision sling -Ajust™. Material and methods:One and the same surgeon has operated all the patients with symptoms of stress urinary incontinence. Ajust was the only performed procedure. Postoperative evaluation consisted of: a standardized interview and examination, a cough test and a PFS-TV for evaluation of urinary continence and tape location. PFS-TV was performed under standardized conditions at rest and during maximum Valsalva maneuver.Results: This is a retrospective analysis of data from a total of 31 patients who attended a control visit between the 36 th and the 50 th month following the operation. Sixteen patients (51.6%) were cured. There were statistically significant differences in urethral mobility (p < 0.0007) and tape-urethra distance (p < 0.002) between cured and not-cured group. The difference in urethral length was not statistically significant. 77.8% of women with a hypermobile urethra was cured in contrast to 15.4% with a normobile urethra. Neither of the groups had a hypomobile urethra patient. There were no significant complications intra-or post-operatively. De novo urgency was observed in 1 patient only.Conclusions: Implantation of Ajust tape seems to be a safe mode of operative treatment for SUI in women. Our mid-term results suggest that long term effects might be worse compared to retropubic or transobturator tapes, especially at first operative experience with Ajust. Urethral mobility seems to be an important risk factor for treatment failure after Ajust implantation. It seems that patients that may benefit from Ajust most are women with urethral hypomobility but this needs to be verified with a prospective study.

“…One pre-pubic and two transobturator needles with removable and ergonomic handles complete the set [12]. All operated women had symptoms of SUI and a cystocele of stage 2 or higher as per Pelvic Organ Prolapse Quantification (POP-Q) system [9,10,20].…”

Section: Methodsmentioning

confidence: 99%

“…SUI and pelvic organ prolapse (POP) are often the reasons for operative treatment, especially in ageing populations [5][6][7][8][9][10][11]. There are no recommendations regarding an optimal surgical intervention in different clinical situations.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously — results controlled with a pelvic floor ultrasound. A preliminary study

Wlaźlak¹,

Kluz²,

Wróbel³

et al. 2017

Objectives: It is controversial whether pelvic organ prolapse and stress urinary incontinence (SUI) should be treated simultaneously with a single surgery or separately with two procedures. The pre-pubic four-arm NAZCA-TC® mesh was invented to treat cystocele and SUI with a single procedure. The objective of this study is to analyze short-term results after the implantation of NAZCA-TC mesh. Material and methods:A total of 18 women underwent the evaluation of results of mesh implantation within a 24 to 36 months follow-up. Pre-operatively, patients were examined under standardized conditions. Postoperatively we analyzed the following: standardized interview and examination as well as pelvic floor ultrasound: 2D with a transvaginal probe and 4D with an abdominal probe.Results: There was one case of intraoperative bladder damage noticed and repaired followed with NAZCA implantation. In 2 cases vaginal erosion was found that healed successfully after re-operation. In 3 cases hematomas were observed but resolved spontaneously. After the surgery there was a statistically significant improvement of prolapse in anterior (p < 0.0003) and in central (p < 0.001) compartment. Six women (33.3%) had no stress urinary incontinence symptoms during the control visit but we did not find a statistically significant improvement in SUI symptoms after the procedure. We recorded no case of hypomobile urethra after the surgery. The mesh covered > 50% of the urethral length in all of the patients. Conclusions:Mid-term results showed that implantation of NAZCA TC mesh allows to achieve statistically significant improvement in reducing cystocele coexisting with enterocele in over 65% of patients. A complete cure from stress urinary incontinence was confirmed in 1/3 of patients. NAZCA-TC covered more than 50% of the urethral length, which can possibly have a negative influence on the effectiveness of the suburethral tape.