Transobturator vaginal tape and colporrhaphy for the simultaneous correction of stress urinary incontinence and vaginal prolapse

Abstract EN

The prevalence of combined stress urinary incontinence (SUI) and vaginal prolapse in Egyptian females is believed to be greatly under-estimated.

Through this study we aimed to provide patients concomitant solutions for their dual problems and consequently assess the subjective and objective outcomes.

A total of 18 women diagnosed with SUI and vaginal prolapse (cystoceles, rectoceles and/or vault prolapse) were enrolled into this pilot study.

All patients were subjected to fixation of a transobturator vaginal polypropylene tape combined with anterior, posterior or combined vaginal repair of their prolapse.

The patients were then evaluated after 1 week, 3 and 6 months post-operatively.

Subjective assessment included the progress of urinary leakage during stress, the number of pads used per day, a quality of life (QoL) questionnaire and the evolution of the prolapse-related symptoms.

Objective assessment included a stress test, a pad test and a vaginal examination to perform pelvic organ prolapse quantification (POP-Q).

Urodynamic were performed in selected cases.

All interventions were uneventful except once when a urethral injury was induced during dissection and instantly repaired.

Two patients failed to resume normal voiding 24 hours post-operatively and catheters were hence kept for 5 more days.

At 6 months follow up, the QoL questionnaire in the study group improved from a mean of 3.9 to 1.3 (p < 0.01).

Cure from SUI was achieved in 14 patients (77.8 %) that they stopped using pads all together and their stress and pad tests were negative.

Improvement in leakage was reported by 2 more patients.

On the other hand, 16 patients (88.9 %) felt relieved as regards their prolapse symptoms.

On vaginal examination, 15 had no evidence of prolapse while 3 had mild cystoceles.

De novo urge was reported by 2 patients (11.1 %), mild straining during voiding by 2 (11.1 %) while vaginal erosions were not encountered.

Conclusions : Insertion of transobturator tapes for correction of SUI in females is a highly safe and acceptably successful procedure.

Concomitant correction of genital prolapse does not seem to jeopardize the safety or the efficacy of the operation.

We recommend combining both procedures whenever the situation dictates.