Predictors of voiding dysfunction following extensive vaginal pelvic reconstructive surgery

Lo, Tsia‐Shu; Shailaja, Nagashu; Hsieh, Wu‐Chiao; Uy-Patrimonio, Ma. Clarissa; Yusoff, Faridah Mohd; Ibrahim, R. A.

doi:10.1007/s00192-016-3144-z

Cited by 46 publications

(37 citation statements)

References 25 publications

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“…Moreover, concomitant MUS surgery was not associated with a higher risk of voiding dysfunction. In contrast, previous studies have reported a significantly increased risk of voiding dysfunction after MUS concomitant with mesh surgery 19,20 and determined risk factors for voiding dysfunction as diabetes mellitus, detrusor pressure at maximal flow <10 cm H 2 O and postvoid residual more than 200 mL.…”

Section: Discussionmentioning

confidence: 76%

Clinical evaluation of the Uphold LITE mesh for the surgical treatment of anterior and apical prolapse: A prospective, multicentre trial

Allegre

Debodinance²,

Dematteï

et al. 2019

Neurourology and Urodynamics

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Aims To evaluate the safety and efficacy of the Uphold LITE mesh in the treatment of pelvic organ prolapse at 12‐month follow‐up. Methods Women undergoing a mesh surgery due to an anterior prolapse plus a symptomatic anterior prolapse (classed as pelvic organ prolapse quantification stage ≥2) were included in this prospective, multicentre, observational study. The primary endpoint was a composite outcome including a good anatomical correction, no prolapse symptoms, and no reintervention for an anterior or apical recurrent prolapse within 12 months of surgery. Secondary outcomes included safety, improvements in quality of life (QoL), and risk factor for recurrence. This study was registered with ClinicalTrials.gov, number NCT01559168. Results A total of 121 patients were included. Symptomatic and anatomic cure rates were 94% (95 of 101) and 76.8% (76 of 99), respectively. The composite success rate was 72.4% (71 of 98). The rate of reoperation for apical or anterior recurrent prolapse was 3.9% (4 of 103). Anatomical anterior or apical recurrence occurred in 18.2% (18 of 97) and 7.2% (7 of 97) of patients, respectively. The composite success rate was significantly higher in centres where more than 30 patients had been treated (80% vs 50%; P = .045). The rate of serious complication was 5.4% (6 of 111). Improvements were recorded in QoL including sexual function. Conclusions The Uphold LITE mesh procedure provides satisfactory outcomes in the treatment of anterior and apical prolapse, particularly in high‐volume centres. The rates of adverse effects and reintervention for recurrent prolapse were acceptable.

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Section: Discussionmentioning

confidence: 76%

Clinical evaluation of the Uphold LITE mesh for the surgical treatment of anterior and apical prolapse: A prospective, multicentre trial

Allegre

Debodinance²,

Dematteï

et al. 2019

Neurourology and Urodynamics

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“…However, the overall incidence of postoperative voiding dysfunction was only 3.5% and 1% developed de novo voiding dysfunction . A detrusor pressure at maximal flow <10 cmH2O found in 3% of the women was the only urodynamic covariate associated with postoperative voiding dysfunction (OR 1.8) . Concurrent MUS insertion was also associated with a higher risk of postoperative voiding dysfunction (OR 3.1) .…”

Section: Discussionmentioning

confidence: 99%

“…One might be reluctant to perform prophylactic incontinence surgery in women with detrusor underactivity or voiding dysfunction. Lo et al found in a considerable number of women with advanced prolapse a sign of bladder outlet obstruction. However, the overall incidence of postoperative voiding dysfunction was only 3.5% and 1% developed de novo voiding dysfunction .…”

Section: Discussionmentioning

confidence: 99%

“…Lo et al found in a considerable number of women with advanced prolapse a sign of bladder outlet obstruction. However, the overall incidence of postoperative voiding dysfunction was only 3.5% and 1% developed de novo voiding dysfunction . A detrusor pressure at maximal flow <10 cmH2O found in 3% of the women was the only urodynamic covariate associated with postoperative voiding dysfunction (OR 1.8) .…”

Section: Discussionmentioning

confidence: 99%

“…A detrusor pressure at maximal flow <10 cmH2O found in 3% of the women was the only urodynamic covariate associated with postoperative voiding dysfunction (OR 1.8) . Concurrent MUS insertion was also associated with a higher risk of postoperative voiding dysfunction (OR 3.1) . Although prolonged bladder catheterization and short term voiding dysfunction seems to be higher in women undergoing prolapse surgery with MUS compared to prolapse surgery only, there is strong evidence that long‐term voiding dysfunction is comparable …”

Section: Discussionmentioning

confidence: 99%

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The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

Ploeg

Zwolsman

Posthuma

et al. 2017

Neurourology and Urodynamics

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Outcomes of bladder outlet obstruction following extensive vaginal pelvic reconstruction surgery on patient with advanced pelvic organ prolapse

Chiung,

Lo,

Ayedh

et al. 2024

Intl J Gynecology & Obste

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ObjectiveTo evaluate the impact of extensive vaginal pelvic reconstruction surgery (PRS) on advanced pelvic organ prolapse (POP) patients with bladder outlet obstruction (BOO).MethodsWe conducted a single‐center, retrospective analysis of women who received extensive vaginal pelvic reconstruction surgery for advanced POP (POP‐Q ≥3) with BOO from January 2006 to January 2016. Data regarding preoperative evaluation, surgical procedure, and postoperative management were abstracted from medical records. Patients were considered to have BOO when detrusor pressure at maximum flow (Dmax) was ≥20 cm H2O and peak flow rate (Qmax) was ≤15 mL/s. Patients with postoperative value of Dmax lower than 20 cm H2O or Qmax higher than 15 mL/s were regarded as objectively cured.ResultsA total of 1894 patients with POP stages III or IV were assessed. The incidence of BOO was 22.8% (431/1894) within this patient population of advanced POP. One year after the vaginal PRS, the objective cure rate of BOO was 98.1%. Urodynamic parameters showed a significant increase in Qmax (P < 0.001), while Dmax (P < 0.001) and postvoid residual urine (PVR) (P < 0.001) were significantly decreased. Previous POP surgery, native tissue repair (NTR), PVR ≥200 mL, and maximal cystometric capacity (MCC) ≥500 mL increase the likelihood of persistent BOO in patients.ConclusionVaginal PRS demonstrated effectiveness in treating BOO in patients with advanced POP. Irrespective of the types of transvaginal mesh (TVM), using TVM achieved better outcome than did NTR. Previous POP surgery, preoperative PVR ≥200 mL, and MCC ≥500 mL were the risk factors predicting the failure of PRS in improving BOO.

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Predictors of voiding dysfunction following extensive vaginal pelvic reconstructive surgery

Cited by 46 publications

References 25 publications

Clinical evaluation of the Uphold LITE mesh for the surgical treatment of anterior and apical prolapse: A prospective, multicentre trial

Clinical evaluation of the Uphold LITE mesh for the surgical treatment of anterior and apical prolapse: A prospective, multicentre trial

The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

Outcomes of bladder outlet obstruction following extensive vaginal pelvic reconstruction surgery on patient with advanced pelvic organ prolapse

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