Hyung Ho Lee1, Dae Keun Kim2, Jae Won Park1, Suk Young Lee1, Woo Jin Ko1, Young Sig Kim3. 1. Department of Urology, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, South Korea. 2. Department of Urology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, South Korea. 3. Department of Urology, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, South Korea. urokim@nhimc.or.kr.
Abstract
INTRODUCTION AND HYPOTHESIS: To evaluate the efficacy of intraoperative extrinsic manual bladder compression (Credé maneuver) for trans-obturator tape adjustment during mid-urethral sling surgery in women with stress urinary incontinence and those with mixed urinary incontinence. METHODS: The study included 148 randomly selected women who underwent mid-urethral sling surgery with trans-obturator tape for stress urinary incontinence between January 2016 and May 2017. Subgroup analysis of 66 women with mixed urinary incontinence included 43 patients from the Credé maneuver group and 23 from the non-Credé maneuver group. In the Credé maneuver group, the pattern of urine leakage was determined during the Credé maneuver, and tape tension was adjusted according to the pattern. RESULTS: The cure rate was 86.6% and improved rate was 11.9% in the Credé maneuver patients. The cure rate was 50.6% and improved rate was 38.3% in the non-Credé maneuver patients. The success rate was significantly higher in the Credé than in the non-Credé maneuver group (p = 0.023). In subgroup analysis of patients with mixed urinary incontinence, the cure rate was 81.4% and improved rate was 16.3% in the Credé maneuver group. The cure rate was 43.5% and improved rate was 47.8% in the non-Credé maneuver group. The cure rate was significantly higher in the Credé maneuver group (p = 0.007). CONCLUSIONS: Intraoperative trans-obturator tape adjustment using the Credé maneuver to identify the leaking pattern significantly improved the success rate in women with mixed urinary incontinence, and Credé maneuver-directed adjustment significantly improved the cure rate.
INTRODUCTION AND HYPOTHESIS: To evaluate the efficacy of intraoperative extrinsic manual bladder compression (Credé maneuver) for trans-obturator tape adjustment during mid-urethral sling surgery in women with stress urinary incontinence and those with mixed urinary incontinence. METHODS: The study included 148 randomly selected women who underwent mid-urethral sling surgery with trans-obturator tape for stress urinary incontinence between January 2016 and May 2017. Subgroup analysis of 66 women with mixed urinary incontinence included 43 patients from the Credé maneuver group and 23 from the non-Credé maneuver group. In the Credé maneuver group, the pattern of urine leakage was determined during the Credé maneuver, and tape tension was adjusted according to the pattern. RESULTS: The cure rate was 86.6% and improved rate was 11.9% in the Credé maneuver patients. The cure rate was 50.6% and improved rate was 38.3% in the non-Credé maneuver patients. The success rate was significantly higher in the Credé than in the non-Credé maneuver group (p = 0.023). In subgroup analysis of patients with mixed urinary incontinence, the cure rate was 81.4% and improved rate was 16.3% in the Credé maneuver group. The cure rate was 43.5% and improved rate was 47.8% in the non-Credé maneuver group. The cure rate was significantly higher in the Credé maneuver group (p = 0.007). CONCLUSIONS: Intraoperative trans-obturator tape adjustment using the Credé maneuver to identify the leaking pattern significantly improved the success rate in women with mixed urinary incontinence, and Credé maneuver-directed adjustment significantly improved the cure rate.
Authors: Kate H Moore; Rihan B Shahab; Colin A Walsh; William M A Kuteesa; Susmita Sarma; Monique Cebola; Wendy Allen; Yueping A Wang; Emmanuel Karantanis Journal: Int Urogynecol J Date: 2011-11-12 Impact factor: 2.894
Authors: Miles Murphy; Patrick J Culligan; Cristina M Arce; Carol A Graham; Linda Blackwell; Michael H Heit Journal: Obstet Gynecol Date: 2005-02 Impact factor: 7.661
Authors: Jennifer M Wu; Catherine A Matthews; Mitchell M Conover; Virginia Pate; Michele Jonsson Funk Journal: Obstet Gynecol Date: 2014-06 Impact factor: 7.661
Authors: Ana Maria H M Bianchi-Ferraro; Zsuzsanna I K Jarmy-DiBella; Rodrigo de Aquino Castro; Maria Augusta T Bortolini; Marair G F Sartori; Manoel J B C Girão Journal: Int Urogynecol J Date: 2014-03-19 Impact factor: 2.894