The urodynamic results in suburethral slings (SS), are contradictory. We evaluate a series on patients with stress urinary incontinence (associated or not with bladder hyperactivity) that underwent suburethral slings (SS) operations.
42 women (age 62±12 years) with urinary incontinence underwent suburethral slings (86% TOT, 12% TVT, 2% others), 36% of them with simultaneous pelvic organ prolapse correction. Medical history and a pre and postsurgery urodynamic studies (according to ICS instructions, except when specified) were performed.
After surgery, the improvement of urinary incontinence was lower in patients with previous detrusor hyperactivity (DH) than without DH (60% vs 81 %), and the bladder capacity (BC) was lower (123±36 ml) in patients with previous mixed urinary incontinence (MUI) versus no MUI (241±83 ml) (p=0.004). The decrease of BC was higher with previous MUI (184±92 ml vs 123±36 ml) versus no MUI (240±91 ml vs 237±78 ml), and the DH was more frequent in previous MUI and DH. There was a significant decrease of maximum flow rate (Qmax) (p=0.000) (although without clinical manifestation), and post void residual urine (p=0.007). We demonstrated a significant increase (p=0.001) of mean urethral resistance (URA): 12±9 cm H2O versus 15±12 cm H2O (without reaching obstruction range), and an improvement of detrusor contractility (W80-20): (3±4 W/m2; vs 6±17 W/m2;).
We demonstrated worst results in MUI in patients with urinary incontinence undergoing SS. The urodynamic study gives a better prognosis reliability in the treatment of female urinary incontinence with SS.
Archivos espanoles de urologia. 2016 May [Epub]
J Salinas-Casado, S Méndez-Rubio, L Pesquera-Ortega, M Vírseda-Chamorro, P Gutiérrez-Martín, L Resel-Folkersma, M Esteban-Fuertes, J Moreno-Sierra
Service of Urology. Hospital Clínico San Carlos. Madrid. Spain., Service of Urology. Hospital Universitario Sanitas La Moraleja. Madrid. Spain., Service of Urology. Hospital Clínico Universitario. Valladolid. Spain., Service of Urology. Hospital Nacional de Parapléjicos. Toledo. Spain., Service of Urology. Hospital General. Talavera de la Reina. Toledo. Spain., Service of Urology. Hospital Clínico San Carlos. Madrid. Spain., Service of Urology. Hospital Nacional de Parapléjicos. Toledo. Spain., Service of Urology. Hospital Clínico San Carlos. Madrid. Spain.