Effect of Simultaneous Cystocele Repair On Transobturator Tape In Patients With Stress Urinary Incontinence

Abstract

Objective In this study, the effect of cystocele repair performed simultaneously with transobturator tape (TOT) on the results of operation was evaluated in patients with stress urinary incontinance (SUI) and pelvis organ prolapsus (POP). Materials and Methods The data of 103 patients who had SUI and cystocele between 2006 and 2012 were evaluated retrospectively. The patients who underwent only TOT was classified as group 1 and the patients who underwent cystocele repair simulatenously with TOT were classified as group 2. The patients in group 2 were divided as group 2a (low grade cystocele (grade 1 and 2)) and group 2b (high grade (grade 3) cystocele ). The age, number of normal deliveries, pad test, cystocele grade, post-operative complications and preop International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) forms were evaluated from the patient files. All patients were questioned by ICIQ-SF in terms of the final continence status. The groups were compared in terms of the above-mentioned parameters. Results It was observed that there was no significant difference between group 1 and group 2 in terms of preoperative ICIQ-SF scores (16.06±0.34 and 16.82±0.42, respectively) and demographic data at the baseline. It was observed that the postoperative ICIQ-SF scores decreased markedly in both groups (3.28±0.78 and 5.41±1.21, respectively, p<0.01). While there was no difference in preoperative ICIQ-SF values in the patients in group 2b in comparison with the patients in group 2a, the postoperative ICIQ-SF scorewas significantly lower. The mean ∆ICIQ-SF score was found to be lower in the patients in group 2a compared to the patients in group 1 and group 2b (8.88±1.98,12.77±0.83, and 13.57±1.42, respectively, p<0.01). Conclusion Conclusively, cystocele repair performed simultaneously with TOT does not provide additional improvement in patients with low grade cystocele, whereas cystocele repair performed simultaneously with TOT provides a more prominent improvement in patients with high grade cystocele

Keywords

• Urinary incontinence; cystocele; stress urinary incontinance; Transobturator tape (TO