Possibilities of a New Technique for Determining Residual Urine in Women After Synthetic Sling Surgery

Abstract

Background: Synthetic sling surgery has become quite a popular method for stress urinary incontinence treatment over the past quarter century. The effectiveness of eliminating urinary incontinence is estimated by various authors from 70% to 95%; however, urinary disorders often develop after surgery. In some cases, conditions underlying incomplete bladder emptying occur. In addition, clinical symptoms of imperative urination disorders appear. They are generally known as de novo and manifest with urinary frequency, imperative urges, and urge incontinence. Literature shows that obstructed urination in women is also common, and synthetic sling surgery is indicated.Objective: To assess the incidence of obstructed urination and development of incomplete bladder emptying in female patients with synthetic tapes placed under the urethra.Material and methods: We observed a group of female patients examined at the Center for “Urination Pathology” (Vladivostok, Russian Federation) for stress urinary incontinence. The mean age in the group (40 cases) was 53.4±4.2 years (range, 35-68 years). All the patients underwent trocar synthetic sling surgery. Home uroflowmetry was performed before surgery and within 3 months after discharge.Results: After synthetic sling surgery, the urination obstruction and probability of residual urine formation were found to increase. At the same time, there was a weak association between preoperative obstruction and difficulty after synthetic tape placement. We measured incomplete bladder emptying using a new technique: by original Russian UFM “SIGMA” uroflowmeter.Conclusions: The study data support the need for widespread use of a new technique of noninvasive urodynamics for residual urine determination. The use of a 2-sensor uroflowmeter with an original algorithm for processing urine flow records is a fundamentally new tool for assessing the functional state of the lower urinary tract that can detect residual urine with a probability of 0.95 and help solve a rather complex clinical problem.

Keywords

• obstructed urination
• urinary incontinence
• synthetic sling surgery
• uroflowmetry