Using TVT Procedure in Combination with Anterior Colporrhapy for Management of Cystocele Combined with Stress Urinary Incontinence: Preliminary Results

Lee, Won Sik; Kim, Sang Hyun; Seo, Ju Tae

Abstract

PURPOSE
We performed a preliminary study to assess the possibility of using Tension-free vaginal tape (TVT) procedure in combination with repair of cystocele (anterior colporrhapy) for management of cystocele and stress urinary incontinence.
MATERIALS AND METHODS
Twelve clinically incontinent women with cystocele were prospectively enrolled. In addition to anterior colporrhapy, these patients underwent concomittant TVT procedure. Among them, ten patients were evaluated preoperatively and postoperatively by questionnaires, urodynamic study, 1 hour pad test, physical examination and urinalysis. The stress urinary incontinence was classified into two categories: anatomical incontinence and intrinsic sphincter deficiency. The cystocele was staged by the POP-Q system.
RESULTS
The mean follow-up interval was 12.2 months (8.3~18.6 months) and the mean age was 57.5 years(45~68 years). All patients had anatomical incontinence. Mean pre- and post-operative Valsalva leak point pressure (VLPP) was 101.1 cmH2O (96~127 cmH2O) and no leakage respectively. And mean pre- and post-operative 1 hour pad test was 10.4 g (1.3~40.9 g) and 1.0 g (0.0~1.9 g) respectively. All cystocele staged by POP-Q system was stage II. The mean Aa point was -0.18 cm (-0.5~ +0.2 cm) preoperatively and lower than -1 cm postoperatively. Only one de novo urgency was developed postoperatively, which was resolved by the use of anticholinergic agent. Other severe intra- and post-operative complications were not observed.
CONCLUSION
This study demonstrates that TVT combined with anterior colporrhapy can be performed to treat effectively symptoms of cystocele and stress urinary incontinenece.