| Mesh Cutting in Patients with Obstructive Symptoms after Tension-free Vaginal Tape Procedure. |
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| Dong Hwan Lee, Joon Chul Kim, Ji Youl Lee, Hong Jin Suh |
1Department of Urology, College of Medicine, Our Lady of Mercy Hospital, The Catholic University of Korea, Seoul, Korea. dhluro@hanmail.net
2Department of Urology, Kang Nam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
3Department of Urology, Holy Family Hospital, The Catholic University of Korea, Seoul, Korea. |
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| ABSTRACT |
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. |
| Keywords:
Tension; Tape; Obstruction |
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