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. 2013 Jul;18(7):588-93.

Concomitant surgical correction of severe stress urinary incontinence and anterior vaginal wall prolapse by anterior vaginal wall wrap: 18 months outcomes

Mahtab Zargham  1 , Farshid Alizadeh  1 , Farhad Tadayyon  1 , Mohammad-Hatef Khorrami  1 , Kia Nouri-Mahdavi  1 , Mohammad Reza Gharaati  1 , Mohammad Hossein Izadpanahi  1 , Mohammad Yazdani  1 , Hamid Mazdak  1
Affiliations

Concomitant surgical correction of severe stress urinary incontinence and anterior vaginal wall prolapse by anterior vaginal wall wrap: 18 months outcomes

Mahtab Zargham et al. J Res Med Sci. 2013 Jul.

Abstract

Background: The aim of this study is to evaluate the outcome of an innovative, minimally invasive sling technique with autologous tissue in women with concomitant incontinence and anterior vaginal wall prolapse (AVWP).

Materials and methods: Fifty-six women with stress urinary incontinence (SUI) or mixed urinary incontinence and AVWP were randomly assigned into two groups: In Group A (26 patients), anterior colporrhaphy (Kelly placation) and sling placement using a strip of anterior vaginal wall were performed, and in Group B (30 patients), transvaginal mesh correction of AVWP and tension-free vaginal tape (TVT) insertion (retropubic - craniocaudal route) using polypropylene mesh were carried out. The patients were followed-up for over 18 months and were assessed objectively using a 48 h frequency-volume chart, a 48 h pad test and a standardized stress test. Related surgical complications and outcomes were recorded and compared.

Results: Surgical cure rates for Group A and Group B at the first (3 days) and last (18 months) post-operative visits were 62% and 84%; and 54%, and 72%, respectively (P = 0.09 and 0.31). Complications occurred in 9 patients (44%) of Group B, but only 3 patients (12%) in Group A.

Conclusion: Vaginal sling surgery using an anterior vaginal wall strip can improve SUI and in comparison with propylene mesh is associated with lower complication rates. Although, the surgical success rate of this technique is lower than T-Sling, larger studies with selected patients will help assess the suitable patients for this pelvic reconstructive surgery.

Keywords: Autologous sling; prolapsed; tension free vaginal mesh; urinary incontinence.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Sling placement using a strip of anterior vaginal wall wrap (Group A or AVW sling)
Figure 2
Figure 2
Transvaginal mesh correction of anterior vaginal wall prolapse and mid-urethral sling using polypropylene mesh (Group B)
Graph 1
Graph 1
The rate of objective and subjective cure rates in different methods AVW, Anterior vaginal wall wrape
See this image and copyright information in PMC

References

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