Document Detail

Is transobturator suburethral sling effective for treating female urodynamic stress incontinence with low maximal urethral closure pressure?
MedLine Citation:
PMID:  21482369     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To assess retrospectively the efficacy and safety of MONARC (American Medical Systems) transobturator suburethral slings in the treatment of female urodynamic stress incontinence with and without low maximal urethral closure pressure (MUCP).
MATERIALS AND METHODS: Seventy-three women with urodynamic stress incontinence, fitted with the transobturator suburethral sling at a medical center in central Taiwan, participated in the study. Objective postoperative evaluations, including a 1-hour pad test, cough stress test, uroflowmetry, and residual urine volume, were conducted 6 months after operation. Subjective outcomes were evaluated by telephone interview. Charts were reviewed for perioperative complications, urinary retention, and requirements for postoperative medication for symptoms of urgency. The mean follow-up was 48 months.
RESULTS: Objective cure rate was 80.8% (dry pad test and negative stress test), 82.4% for MUCP less than 30cmH(2)O, and 80.4% for MUCP greater than 30cmH(2)O (p=1.000). Mean pad weight gain changed from 25.8g preoperatively to 1.8g postoperatively (p<0.05). There was no significant change in urinary flow rate or residual volume. Subjectively, 98.6% of subjects experienced complete improvement; only one patient found no improvement. Very few perioperative complications occurred. Immediate postoperative difficulty in voiding occurred in 6.8% of patients. Postoperative de novo urgency was 2.7%.
CONCLUSIONS: The MONARC transobturator suburethral sling is a safe and highly effective treatment for stress urinary incontinence even in women with low MUCP at a mean follow-up of 48 months. Evaluation of the outcomes after a longer follow-up period is necessary.
Mou-Jong Sun; Horng-Der Tsai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Taiwanese journal of obstetrics & gynecology     Volume:  50     ISSN:  1875-6263     ISO Abbreviation:  Taiwan J Obstet Gynecol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-04-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101213819     Medline TA:  Taiwan J Obstet Gynecol     Country:  China    
Other Details:
Languages:  eng     Pagination:  20-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011. Published by Elsevier B.V.
Division of Urogynecology and Reconstructive pelvic surgery, Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; General Education Center, Chienkuo Technology University, Changhua, Taiwan.
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