For women dealing with stress urinary incontinence due to pelvic organ prolapse, research from Taiwan points to a new treatment. Combining a midurethral sling with a trocar-guided transvaginal mesh surgery may help alleviate the symptoms more effectively than other treatment options.
The study followed a pool of 89 patients who had both procedures performed simultaneously for an average time of 35 months. In addition to the two aforementioned procedures, 17 of the patients had concurrent vaginal hysterectomies, 20 had vault suspension and 52 had uterine suspension.
Positive Results Seen Early
For these patients, all parameters of the Pelvic Organic Prolapse Quantification improves over the first six months of the study. At the six month mark, 69 patients had urodynamics testing, showing significantly higher maximum flow rate and mean flow rate combined with a much lower post-void residual urine volume and maximum urethral closure pressure. They also had a much better one-hour pad test result.
Some of the patients, 29 to be exact, had persistent overactive bladder symptoms. The researchers noted that these symptoms were treated using antimuscarinic treatment. Of the patients with preoperative voiding difficulty, 96.5% were successfully treated. A total of 20 of the patients had postoperative stress urinary incontinence.
The study was performed at the Chi Mei Foundation Hospital in Tainan under the leadership of Ming-Ping Wu. It was published in the Taiwanese Journal of Obstetrics & Gynecology, and the researchers concluded that the combined technique provides a good option for treating women with stress incontinence and pelvic organ prolapse, but they did not conclude that it was the only option. This type of intervention has a higher risk of technique-related problems, like internal bleeding and organ injury. Also, researcher warned that no treatment is a one-size-fits-all solution, no matter what the circumstances, so all patients need to discuss their treatment options with their doctors.
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