Maria Lee1,2, Se-Gyeong Joo1, Tae Yeon Kim1, Eun-Hee Yoo3, Myung Jae Jeon4,5. 1. Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea. 2. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. 3. Department of Obstetrics and Gynecology, Kyung Hee University Medical College, Seoul, South Korea. 4. Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea. jeonmj@snu.ac.kr. 5. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. jeonmj@snu.ac.kr.
Abstract
INTRODUCTION AND HYPOTHESIS: The aim of this study was to report the long-term outcomes after sacrocolpopexy (SCP) with or without transobturator tape (TOT). METHODS: We conducted a planned secondary analysis of a prospective, observational study comparing urinary outcomes in women who underwent SCP with or without TOT based on the results of a prolapse-reduction stress test. Patients were enrolled between November 2008 and December 2011 and were followed up 5 years after surgery. The primary outcomes were 5-year success rates for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) estimated using the Kaplan-Meier method. SUI success was defined as a negative cough stress test, no bothersome SUI symptoms, and no additional anti-incontinence surgery. POP success was defined as no vaginal bulge symptoms, no apical descent greater than one-third of the total vaginal length or anterior or posterior vaginal wall prolapse beyond the hymen, and no retreatment for prolapse. RESULTS: Of 240 women enrolled, 175 (73%) completed 5 years of follow-up. The estimated SUI success rate was 91.1% in the TOT group and 56.5% in the no TOT group (difference, 34.6%; 95% confidence interval, 24.1 to 45.1). The estimated POP success rate was 90.0% in the TOT group and 92.9% in the no TOT group (difference, -2.9%; 95% confidence interval, -10.7 to 4.9). CONCLUSIONS: The advantage of concomitant TOT for SUI after SCP that was seen at 2 years remained at 5 years. Long-term POP failure rates after SCP are low and not affected by concomitant TOT.
INTRODUCTION AND HYPOTHESIS: The aim of this study was to report the long-term outcomes after sacrocolpopexy (SCP) with or without transobturator tape (TOT). METHODS: We conducted a planned secondary analysis of a prospective, observational study comparing urinary outcomes in women who underwent SCP with or without TOT based on the results of a prolapse-reduction stress test. Patients were enrolled between November 2008 and December 2011 and were followed up 5 years after surgery. The primary outcomes were 5-year success rates for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) estimated using the Kaplan-Meier method. SUI success was defined as a negative cough stress test, no bothersome SUI symptoms, and no additional anti-incontinence surgery. POP success was defined as no vaginal bulge symptoms, no apical descent greater than one-third of the total vaginal length or anterior or posterior vaginal wall prolapse beyond the hymen, and no retreatment for prolapse. RESULTS: Of 240 women enrolled, 175 (73%) completed 5 years of follow-up. The estimated SUI success rate was 91.1% in the TOT group and 56.5% in the no TOT group (difference, 34.6%; 95% confidence interval, 24.1 to 45.1). The estimated POP success rate was 90.0% in the TOT group and 92.9% in the no TOT group (difference, -2.9%; 95% confidence interval, -10.7 to 4.9). CONCLUSIONS: The advantage of concomitant TOT for SUI after SCP that was seen at 2 years remained at 5 years. Long-term POP failure rates after SCP are low and not affected by concomitant TOT.
Entities:
Keywords:
Pelvic organ prolapse; Sacrocolpopexy; Stress urinary incontinence; Transobturator tape