Background: This retrospective cohort study assessed the outcomes of combined surgeries for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) in 31 patients with a follow-up of 7 years. Objectives: The study aimed to determine the success and recurrence rates of POP and SUI while comparing the outcomes, analyzing the predictors for recurrence, and reporting on complications. Materials and Methods: Demographic and clinical profiles were analyzed descriptively using frequency and percentages. Objective SUI cure rate was assessed via office cystometry with a cough stress test, while POP was evaluated using the POP-Q system. Subjective cure rates for both conditions were determined using a symptom severity checklist based on the King's Health Questionnaire. Chi-square tests assessed associations between objective outcome parameters and time elapsed since surgery, and other outcome predictors, with significance set at p < 0.05. Results: The results showed a high objective cure rate of 96% for SUI and subjective cure rates of 96% for both SUI and POP. Long-term symptoms included urine frequency and retention, while mesh erosion occurred in one patient. The objective cure rate for POP was 67.7%, with recurrence in the anterior compartment at the midterm and in various compartments at long term. Vault fixation suggests efficacy in reducing apical prolapse recurrence. The preoperative age was identified as a significant risk factor for POP recurrence. Conclusion This study supports the durability and efficacy of combined surgeries for SUI and POP, with high patient satisfaction.
Suburethral Slings

TVT (Tension Free Vaginal Tape) is a new simple surgical procedure, with good postoperative outcomes. However, there are possibilities of major complications, which should be considered, such as massive bleeding, bladder or bowel perforations and nerve injury. There is little information on treatment of obturator neuropathy as a result of nerve compression, or injury, caused by a more lateral placement of tape following a TVT procedure. To prevent this complication, the patient's legs should be correctly positioned, enough abduction and not exceeding 60 degrees to avoid excessive flexion.
Hemorrhage ; Leg ; Suburethral Slings* ; Urinary Bladder

PURPOSE: Tension-free vaginal tape(TVT) procedure is widely used as an initial operative method in stress urinary incontinence because of high success rate and low morbidity. However, some patients have complained of voiding difficulties after TVT. We evaluated 14 patients who underwent mesh cutting because of obstructive symptoms after TVT. MATERIALS AND METHODS: 14 patients who underwent mesh cutting because of prolonged obstructive symptoms after TVT were included for the study. Their voiding symptoms were evaluated by Qmax, voiding time and postvoid residual urine. These parameters which were done before TVT, post-TVT and post-mesh cutting were compared. RESULTS: 4 out of 14 patients were intrinsic sphincter deficiency(valsalva leak point pressure <60 cmH2O) and no patient had detrusor overactivity before TVT. After TVT, Qmax was decreased from 25.4+/-3.5 ml/sec to 9.4+/-2.4 ml/sec, and voiding time was prolonged from 26.7+/-6.6 sec to 65.5+/-24.8 sec. However, the volume of postvoid residual urine was unchanged. After mesh cutting, Qmax was increased to 21.7+/-7.7 ml/sec and voiding time was decreased to 27.2+/-7.6 sec. Subjective voiding symptoms were improved immediately in 13 out of 14 patients(92.9%), although 1 patient showed small amount of urine leakage when coughing. And also, in 1 out of 2 patients, detrusor overactivity which was shown after TVT was disappeared. CONCLUSION: We believe that we do not need to hesitate to cut the mesh in patients who are suffering from severe obstructive symptoms after TVT.
Cough ; Humans ; Suburethral Slings* ; Urinary Incontinence

Tension-free vaginal tape (TVT) has been accepted for a therapeutic modality of stress incontinence and presented as easy, safe, effective, and time-saving procedure with cure rate of more than 86% and another 11% significantly improved with no serious complication. However, there is not always safe without severe complications, because the TVT needle has to pass blindly through the pelvic cavity. Furthermore, it may be very serious once it happened. We, herein, present a case who bled to shock following TVT procedure but was controlled conservatively, and review its complications in the literatures.
Needles ; Shock ; Suburethral Slings* ; Vascular System Injuries*

Midurethral tension-free sling procedure has become one of the most popular techniques for the treatment of stress urinary incontinence. As the time elapsed, however, complications associated with a synthetic tape have been reported to occur. Recently, we experienced a rare case of urethral erosion with perineal cellulitis at anterior wall of vagina after midurethral sling procedure. So our experience was presented with a review of literature.
Cellulitis ; Suburethral Slings ; Urethra ; Urinary Incontinence ; Vagina

Various postoperative complications have been reported after the use of tension-free vaginal tapes (TVT). The transobturator approach was introduced to minimize the potential complications. The next generation of recently introduced TVT-SECUR is intended to minimize the incidence of complications. Herein we report a case of internal pudendal artery injury sustained during this procedure that was successfully treated by radiological embolization. Angiography with vessel embolization, when available, should be considered when the arterial injury is suspected.
Angiography ; Arteries ; Glycosaminoglycans ; Incidence ; Postoperative Complications ; Suburethral Slings ; Urinary Incontinence

PURPOSE: Some women choose to undergo posterior colporrhaphy (PC) concurrently with procedures for SUI to regain sexual confidence and improve sexual function. We determine the effect of PC on sexual function in women requiring a midurethral sling for SUI. MATERIALS AND METHODS: A total of 119 women were retrospectively reviewed 81 women had the midurethral sling alone (Group A), and 38 women voluntarily had PC concurrently with the midurethral sling (Group B). Sexual function was evaluated using the FSFI before and after surgery. RESULTS: The postoperative composite scores were significantly increased in both groups (Group A: p=0.02; Group B: p=0.04), and significant increases were observed in 'desire,' 'arousal' and 'satisfaction'. However, there were no significant differences in the composite score or six domainscores between the two groups. CONCLUSION: PC performed concurrently with midurethral sling for treatment of SUI does not provide any additional benefits towards improving the sexual function.
Female ; Humans ; Retrospective Studies ; Suburethral Slings ; Urinary Incontinence

The transobturator tape (TOT) method is the recent minimally invasive midurethral sling surgery. The TOT method was invented to reduce complication rate of surgical technique for female stress urinary incontinence. Pelvic bleeding following TOT procedure, although extremely rare, could be occurred. We presented three cases which treat pelvic arterial bleeding after midurethral sling (TOT and tension-free vaginal tape Secur) surgery via pelvic artery embolization. Therefore we report our cases with brief review of the literature.
Arteries* ; Female ; Hemorrhage* ; Humans ; Suburethral Slings* ; Urinary Incontinence*

Most of anti-incontinence surgeries bear the risk of postoperative complication such as voiding dysfunction due to urethral obstruction. Fortunately, Tension Free Vaginal Tape(TVT) procedure has much lower incidence of postoperative urethral obstruction than other surgical procedures for stress urinary incontinence. There are many reports about the surgical treatments for short-term urethral obstruction after TVT procedure. However, there are few reports on the effect of surgical releasing of the obstruction lasting for a long period. In our case, the patient had urethral obstruction for 32 months after TVT procedure and she was able to void well after surgical releasing of the tape. We suggest that releasing of the tape will be a treatment of choice for long-term urethral obstruction after TVT procedure.
Humans ; Incidence ; Postoperative Complications ; Suburethral Slings* ; Urethral Obstruction* ; Urinary Incontinence

The management of postprostatectomy urinary incontinence (PPI) is still challenging for urologists. In recent decades, various kinds of male sling system have been developed and introduced; however, they have not yet shown as good a result as that of artificial urinary sphincter (AUS). However, a male sling is still in an important position because patients have a high demand for sling implantation, and it can allow the avoidance of the use of mechanical devices like AUS. Recently, the male sling has been widely used in mild-to-moderate PPI patients; however, there are no studies that compare individual devices. Thus, it is hard to directly compare the success rate of operation, and it is impossible to judge which sling system is more excellent. It is expected that many sling options will be available in addition to AUS in the near future with the technological development of various male slings and the accumulation of long-term surgical outcomes. In that in patients with PPI, sling implantation is an option that must be explained rather than an option that need not be explained to them, this review would share the latest outcomes and complications.
Humans ; Male ; Prostatectomy ; Suburethral Slings ; Urinary Incontinence ; Urinary Sphincter, Artificial