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The influence of preoperative bladder outlet obstruction on continence and satisfaction in patients with stress urinary incontinence after midurethral sling.

Kim SJ, Choi HW, Cho HJ, Hwang TK, Kim JC - Int Neurourol J (2010)

Bottom Line: There were no significant differences in continence rates, satisfaction, or postoperative maximal flow rate between the 3 groups.Postoperative urgency was improved after surgery in Groups I and II (P<0.05) but not in Group III.BOO does not seem to be a risk factor for failure after the midurethral sling procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Bucheon St. Mary's Hospital, The Catholic University of Korea School of Medicine, Bucheon, Korea.

ABSTRACT

Purpose: We studied the influence of preoperative bladder outlet obstruction (BOO) on postoperative continence rates and patient satisfaction after the midurethral sling procedure.

Methods: A total of 159 women who underwent the midurethral sling procedure were evaluated. Using the Blaivas-Groutz nomogram, we assigned the patients were assigned to Group I (n=37, no obstruction), Group II (n=89, mild obstruction), or Group III (n=33, moderate to severe obstruction). Continence rates, patient satisfaction, urinary sensation scale and uroflowmetry were evaluated postoperatively.

Results: There were no significant differences in continence rates, satisfaction, or postoperative maximal flow rate between the 3 groups. Postoperative urgency was improved after surgery in Groups I and II (P<0.05) but not in Group III.

Conclusions: BOO does not seem to be a risk factor for failure after the midurethral sling procedure. However, BOO may be considered as a potential factor for persistent storage symptoms after the midurethral sling.

No MeSH data available.


Related in: MedlinePlus

Changes of preoperative (preop) and postoperative (postop) postvoid residual urine volume (PVR). a)P<0.05 compared with preop PVR.
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Figure 2: Changes of preoperative (preop) and postoperative (postop) postvoid residual urine volume (PVR). a)P<0.05 compared with preop PVR.

Mentions: The mean patient age was 55.6±8.4 years (range, 39 to 72 years) and the mean follow-up period was 24.3±9.6 months (range, 12 to 45 months). BOO was diagnosed in 122 of the 159 patients with SUI (77%); mild obstruction was observed in 89 (56%) and moderate to severe obstruction was observed in 33 (21%). There were no significant differences in the cure rates (Group I, 83.8%; Group II, 85.4%; Group III, 84.8%), and there was no significant difference in patient satisfaction (Group I, 89.2%; Group II, 91.0%; Group III, 87.8%) (Table 1). There were no significant differences between the preoperative and postoperative Qmax value within each group. However, a significantly lower preoperative Qmax was observed in Group III (20.5±5.7 mL/sec) than in Group I (24.5±5.7 mL/sec). The postoperative Qmax was also significantly lower in Group III (24.5±5.7 mL/sec) than in Group I (26.8±9.1 mL/sec) (Fig. 1). The preoperative and postoperative PVR were not significantly different among the 3 groups. However, PVR was significantly increased in each group postoperatively (P<0.05). The preoperative and postoperative PVR were 19.7±50.5 mL and 34.3±38.0 mL in Group I, 10.2±18.3 mL and 31.1±30.5 mL in Group II and 16.4±37.5 mL and 47.1±44.1 mL in Group III (Fig. 2). The preoperative urgency grade from the urinary sensation scale of Groups I, II and III were 3.1±1.5, 2.9±1.5 and 2.5±1.7, respectively and there were no significant differences among the groups. The postoperative urgency grades by urinary sensation scale in Groups I, II, and III were 1.5±1.0, 1.8 ±0.9 and 1.9±1.1, respectively, and there were no significant differences among the groups. The postoperative symptom of urgency was significantly improved after the midurethral sling in Groups I and II (P<0.05). However, there was no improvement in urgency in Group III (Fig. 3). Six women complained of voiding difficulties during the follow-up period. Among them, 3 women belonged to Group I and the rest belonged to Groups II and III.


The influence of preoperative bladder outlet obstruction on continence and satisfaction in patients with stress urinary incontinence after midurethral sling.

Kim SJ, Choi HW, Cho HJ, Hwang TK, Kim JC - Int Neurourol J (2010)

Changes of preoperative (preop) and postoperative (postop) postvoid residual urine volume (PVR). a)P<0.05 compared with preop PVR.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3021820&req=5

Figure 2: Changes of preoperative (preop) and postoperative (postop) postvoid residual urine volume (PVR). a)P<0.05 compared with preop PVR.
Mentions: The mean patient age was 55.6±8.4 years (range, 39 to 72 years) and the mean follow-up period was 24.3±9.6 months (range, 12 to 45 months). BOO was diagnosed in 122 of the 159 patients with SUI (77%); mild obstruction was observed in 89 (56%) and moderate to severe obstruction was observed in 33 (21%). There were no significant differences in the cure rates (Group I, 83.8%; Group II, 85.4%; Group III, 84.8%), and there was no significant difference in patient satisfaction (Group I, 89.2%; Group II, 91.0%; Group III, 87.8%) (Table 1). There were no significant differences between the preoperative and postoperative Qmax value within each group. However, a significantly lower preoperative Qmax was observed in Group III (20.5±5.7 mL/sec) than in Group I (24.5±5.7 mL/sec). The postoperative Qmax was also significantly lower in Group III (24.5±5.7 mL/sec) than in Group I (26.8±9.1 mL/sec) (Fig. 1). The preoperative and postoperative PVR were not significantly different among the 3 groups. However, PVR was significantly increased in each group postoperatively (P<0.05). The preoperative and postoperative PVR were 19.7±50.5 mL and 34.3±38.0 mL in Group I, 10.2±18.3 mL and 31.1±30.5 mL in Group II and 16.4±37.5 mL and 47.1±44.1 mL in Group III (Fig. 2). The preoperative urgency grade from the urinary sensation scale of Groups I, II and III were 3.1±1.5, 2.9±1.5 and 2.5±1.7, respectively and there were no significant differences among the groups. The postoperative urgency grades by urinary sensation scale in Groups I, II, and III were 1.5±1.0, 1.8 ±0.9 and 1.9±1.1, respectively, and there were no significant differences among the groups. The postoperative symptom of urgency was significantly improved after the midurethral sling in Groups I and II (P<0.05). However, there was no improvement in urgency in Group III (Fig. 3). Six women complained of voiding difficulties during the follow-up period. Among them, 3 women belonged to Group I and the rest belonged to Groups II and III.

Bottom Line: There were no significant differences in continence rates, satisfaction, or postoperative maximal flow rate between the 3 groups.Postoperative urgency was improved after surgery in Groups I and II (P<0.05) but not in Group III.BOO does not seem to be a risk factor for failure after the midurethral sling procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Bucheon St. Mary's Hospital, The Catholic University of Korea School of Medicine, Bucheon, Korea.

ABSTRACT

Purpose: We studied the influence of preoperative bladder outlet obstruction (BOO) on postoperative continence rates and patient satisfaction after the midurethral sling procedure.

Methods: A total of 159 women who underwent the midurethral sling procedure were evaluated. Using the Blaivas-Groutz nomogram, we assigned the patients were assigned to Group I (n=37, no obstruction), Group II (n=89, mild obstruction), or Group III (n=33, moderate to severe obstruction). Continence rates, patient satisfaction, urinary sensation scale and uroflowmetry were evaluated postoperatively.

Results: There were no significant differences in continence rates, satisfaction, or postoperative maximal flow rate between the 3 groups. Postoperative urgency was improved after surgery in Groups I and II (P<0.05) but not in Group III.

Conclusions: BOO does not seem to be a risk factor for failure after the midurethral sling procedure. However, BOO may be considered as a potential factor for persistent storage symptoms after the midurethral sling.

No MeSH data available.


Related in: MedlinePlus