Lower urinary tract symptoms in female patients with pelvic organ prolapse: Efficacy of pelvic floor reconstruction

Abstract

Abbreviations & AcronymsObjective: To evaluate the impact of pelvic floor reconstruction on lower urinary tract symptoms in patients with pelvic organ prolapse. Methods: We carried out a prospective study at a single institution. A total of 223 female patients who underwent tension-free vaginal mesh surgery for pelvic organ prolapse between January 2006 and February 2010 were enrolled and prospectively evaluated. A total of 171 cases with concurrent stress urinary incontinence (76% of all cases) underwent concomitant transobturator tape sling. For evaluation of lower urinary tract symptoms, parameters included International Prostate Symptom Score, its quality of life score, International Consultation on Incontinence Questionnaires Short Form, overactive bladder questionnaire, maximal flow rate and postvoid residual. These parameters were evaluated at baseline, and at 3, 6 and 12 months after the surgery. Results: The severity of International Prostate Symptom Score total scores significantly correlated with preoperative pelvic organ prolapse quantification stages, overactive bladder questionnaire total scores and International Consultation on Incontinence Questionnaires Short Form scores. A total of 37% of stage 4 showed ≥20 International Prostate Symptom Score (severe cases). Postvoid residual significantly increased in stage 4 compared with stage 2. Tension-free vaginal mesh improved International Prostate Symptom Score, overactive bladder questionnaire and International Consultation on Incontinence Questionnaires Short Form significantly, and also achieved grade 0 pelvic organ prolapse quantification in 91% of all cases at 1 year after surgery. Postvoid residual values significantly improved and remained stable for 1 year. Worse overactive bladder questionnaire score was a significant predictive factor for poor postoperative International Prostate Symptom Score. Conclusion:The tension-free vaginal mesh plus transobturator tape procedure improves lower urinary tract symptoms in the majority of patients presenting pelvic organ prolapse.Key words: lower urinary tract symptoms, pelvic organ prolapse, quality of life, tensionfree vaginal mesh.

Anatomical and Functional Outcomes of Prolift Transvaginal Mesh for Treatment of Pelvic Organ Prolapse

“…Obinata et al. reported an anatomical cure (defined as POP‐Q stage 0) rate of 91% at 12 months with improved lower urinary tract symptoms . and Miller et al.…”

Tension‐free vaginal mesh surgery versus laparoscopic sacrocolpopexy for pelvic organ prolapse: Analysis of perioperative outcomes using a Japanese national inpatient database

“…The proportion of adverse events was higher in the TVM group; however, considering the lower cost burden in the TVM group, they were likely to be minor adverse events. Several previous studies on TVM carried out in high‐volume hospitals showed significant improvement in terms of voiding function and sexual function after the surgery . These findings suggest that the performance of TVM surgery by experienced surgeons in high‐volume centers could achieve lower complication rates.…”

“…Several previous studies on TVM carried out in high-volume hospitals showed significant improvement in terms of voiding function and sexual function after the surgery. 11,[23][24][25] These findings suggest that the performance of TVM surgery by experienced surgeons in high-volume centers could achieve lower complication rates.…”

Advances in Female Urology: A Review of the 2013 Literature

“…A recent prospective study on 223 female patients undergoing tension-free vaginal mesh surgery for POP, found a post-operative improvement of LUTS in the majority of patients presenting with POP. This study also identified that a lower (e.g., worse) score on an OAB questionnaire was a significant predictive factor for poor post-operative International Prostate Symptoms Score when evaluating the severity of LUTS in both men and women (Hsiao, Lin, & Kuo, 2013;Obinata et al, 2013) (level of evidence = 2).…”