LeFort colpocleisis and stress incontinence: weighing the risk of voiding dysfunction with sling placement

Introduction and hypothesis This study aims to evaluate clinical outcomes of concomitant suburethral sling with LeFort colpocleisis including its effect on postoperative voiding. Methods We performed a retrospective review of all LeFort colpocleisis procedures from our institution. We reviewed demog...

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Published inInternational Urogynecology Journal Vol. 22; no. 11; pp. 1357 - 1362
Main Authors Smith, Aimee L., Karp, Deborah R., Lefevre, Roger, Aguilar, Vivian C., Davila, G. Willy
Format Journal Article
LanguageEnglish
Published London Springer-Verlag 01.11.2011
Springer Nature B.V
Subjects
Aged
Aged, 80 and over
Female
Gynecology
Humans
Medicine
Medicine & Public Health
Original Article
Pelvic Organ Prolapse - surgery
Retrospective Studies
Suburethral Slings
Treatment Outcome
Urinary Incontinence, Stress - surgery
Urodynamics
Urology
Vagina - surgery
Voiding dysfunction
Colpocleisis
Retention
Stress incontinence
Sling
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Summary:Introduction and hypothesis This study aims to evaluate clinical outcomes of concomitant suburethral sling with LeFort colpocleisis including its effect on postoperative voiding. Methods We performed a retrospective review of all LeFort colpocleisis procedures from our institution. We reviewed demographics, symptoms of stress urinary incontinence, incontinent events/day, pads usage/day, urodynamic parameters, and presence of voiding dysfunction. Results Two hundred ten patients underwent colpocleisis during the study period. Mean age was 82.2 ± 4.9 and median follow-up was 22 weeks (2–169). Preoperatively, 73 (35%) complained of stress urinary incontinence (SUI) symptoms, and an additional 105 (50%) were diagnosed with occult SUI. One hundred sixty-one (77%) patients underwent concurrent suburethral sling. Overall, sling placement resulted in a 92.5% subjective stress continent rate. Fifty-six patients presented with voiding dysfunction (VD). Postoperatively, VD resolved in 91%. De novo VD occurred in two patients (1.9%) and one (0.6%) required sling revision. Conclusions Sling placement at time of colpocleisis is associated with high continence rates with minimal risk of postoperative voiding dysfunction.
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ISSN:0937-3462
1433-3023
DOI:10.1007/s00192-011-1441-0