Document Detail


Cadaveric prolapse repair with sling: intermediate outcomes with 6 months to 5 years of followup.
MedLine Citation:
PMID:  15758758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We present the prospective, intermediate-term results for cadaveric prolapse repair with sling as combined treatment of stress urinary incontinence and cystocele. MATERIALS AND METHODS: A total of 251 of 295 (85%) patients undergoing cadaveric prolapse repair with sling (CaPS) had at least 6 months of questionnaire and pelvic examination followup. All patients had objectively demonstrated stress urinary incontinence and grade 2 to 4 cystocele before surgery. Followup outcome measures included a validated subjective continence and patient satisfaction questionnaire, SEAPI (stress incontinence, emptying, anatomy, protection, inhibition) scores, pelvic examination for prolapse recurrence and complications, and quality of life scores. RESULTS: The overall patient reported subjective incontinence cured/dry rate (no incontinence episodes of any type) was 114 of 251 (45%), the cured/improved rate (50% improvement or greater) was 192 of 251 (76%) and the failed rate (less than 50% improvement) was 59 of 251 (24%). When considering stress urinary incontinence the cured/dry rate was 141 of 251 (56%), cured/improved rate was 207 of 251 (82%) and failed rate was 44 of 251 (17.5%), with 17 of the 44 (39%) cases having mixed urinary incontinence. Of the 59 failures 33 (56%) occurred after 12 months of followup. Of 153 patients 13 (8.5%) experienced de novo urge incontinence. The symptomatic cystocele recurrence rate was 18 of 251 (7%). There were statistically significant improvements in SEAPI and prolapse quality of life scores. Of 251 patients 200 (80%) were at least 50% satisfied and of 251 193 (77%) stated they would undergo the CaPS procedure again. CONCLUSIONS: With a maximum followup of 5 years in patients undergoing CaPS, we have seen excellent, durable cystocele repair results. While our subjective continence rates have decreased with an increasing number of late failures, we continue to observe significant improvement in SEAPI scores and quality of life with good patient satisfaction and low morbidity.
Authors:
Robert W Frederick; Gary E Leach
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  173     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-10     Completed Date:  2005-04-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1229-33     Citation Subset:  AIM; IM    
Affiliation:
Tower Urology Institute for Continence, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Attitude to Health
Cadaver
Fascia Lata / transplantation*
Female
Follow-Up Studies
Humans
Middle Aged
Patient Satisfaction
Postoperative Complications
Prolapse
Prospective Studies
Quality of Life
Recurrence
Treatment Outcome
Urinary Bladder / physiopathology
Urinary Bladder Diseases / psychology,  surgery*
Urinary Incontinence, Stress / psychology,  surgery*
Urination / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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