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Purpose: Suburethral tapes are a standard surgical treatment for stress urinary incontinence. The aim of the study was to evaluate subjective and objective cure rates 10 years after a tension-free vaginal tape-obturator procedure., Materials and Methods: All 124 patients who underwent the tension-free vaginal tape-obturator procedure at a total of 2 centers in 2004 and 2005 were invited for followup. Objective cure was defined as a negative cough stress test at 300 ml. Subjects completed KHQ (King's Health Questionnaire), IOQ (Incontinence Outcome Questionnaire), FSFI (Female Sexual Function Index Questionnaire) and PGI-I (Patient Global Impression of Improvement)., Results: Overall, 55 of 112 women (49%) who were alive were available for clinical examination and 71 (63%) completed the questionnaires. The objective cure rate in the 55 women examined clinically was 69%, 22% were not cured and 9% (5) had undergone reoperation for recurrent or persistent stress urinary incontinence. Treatment was counted as having failed in these 5 women for study purposes. Subjective cure was reported by 45 of 71 women (64%). Three patients (5%) had vaginal tape extrusion at the time of clinical examination. Extrusion in all of them was small and asymptomatic, and did not require treatment for a cumulative extrusion rate of 7%. Six women (9%) had undergone reoperation for tension-free vaginal tape-obturator associated complications and 18 (26%) experienced de novo overactive bladder., Conclusions: Subjective and objective cure rates 10 years after the tension-free vaginal tape-obturator procedure were 69% and 64%, respectively. The vaginal extrusion rate in this study was slightly higher than in other series but major long-term complications appeared to be rare., (Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Two patients in whom the right ureter was inadvertently catheterized at water cystometry are described. Accidental ureteral catheterization and filling was followed by colicky pain in the right flank and by an abrupt increase in the recorded pressure, up to 148 cm H2O. The pain disappeared and the intravesical pressure returned to baseline after the microtip catheter was withdrawn.

Objective: To evaluate results 5 years after anterior colporrhaphy with or without needle suspension of the bladder neck and after Burch colposuspension., Methods: 186/291 women (64%) operated on between 1989 and 1990 underwent clinical and urodynamic reevaluation., Results: Objective continence rates after anterior colporrhaphy were 80% (20/25), 46% (22/47) and 12.5% (1/8) in patients with first-, second- and third-degree stress incontinence according to Ingelman-Sundberg. Continence rates in patients with second- and third-degree stress incontinence were 59% (29/49) after additional needle suspension and 86% (50/58) after the Burch procedure., Conclusions: Anterior colporrhaphy can cure mild stress incontinence but is not indicated for severe incontinence. The Burch procedure provides the best continence rates in patients with severe stress incontinence.

Objective: To compare the separation in time of urethral and bladder pressure pulses and urodynamic parameters after successful and unsuccessful anterior colporrhaphy and needle suspension of the bladder neck in patients with stress urinary incontinence., Study Design: Retrospective evaluation of urethral pressure profiles at rest and under stress in 10 successfully and 10 unsuccessfully operated patients., Results: In the successfully treated group, the onset of the urethral pressure increase preceded that of the bladder pressure by an average of 300 ms. Pressure transmission ratios in the 3 proximal quartiles of the urethra were significantly improved after successful surgery. Women who remained incontinent showed neither an advanced onset of the urethral pressure pulse during stress nor improved pressure transmission ratios., Conclusion: Successful anterior repair and needle suspension of the bladder neck support the bladder neck and thus improve the pressure transmission to the urethra. Improved pressure transmission is associated with the finding that pressure increases in the urethra precede those in the bladder in continent women.

This study aimed to investigate the influence of anterior repair on pudendal nerve terminal motor latency. Neurourodynamic investigation (urethral profilometry, measurement of pudendal nerve terminal motor latency according to the method of Snooks and Swash) was performed before and 8 weeks after anterior repair (n = 14) and before and after additional endoscopic bladder neck suspension (n = 23). Stress incontinence and pudendal neuropathy were found preoperatively in all patients. In 17/37 (48%) of patients who were incontinent postoperatively the pudendal nerve latency was significantly prolonged.

This study aimed to compare pelvic floor exercise only (group A) with pelvic floor exercise plus vaginal cones (group B) for the treatment of stress urinary incontinence. 46 premenopausal women were randomized into two groups. The subjective improvement or cure rates were 85.5% in group A and 84.5% in group B. Urethral pressure profiles showed a significant improvement in the transmission factor in the midurethra in each group and for the maximum urethral closure pressure in group A.

70 women were evaluated clinically and urodynamically both before and, on average 16 (12-48) months after undergoing endoscopic suspension of the bladder neck, following Stamey, for genuine stress urinary incontinence. The average age of the patients at surgery was 52 (35-85) years; the average parity was 3 (0-10). Preoperative and postoperative lateral colpocystograms were performed on 48 patients. 40 patients had marked descent of the pelvic organs; 30 patients had previously undergone vaginal hysterectomy and anterior colporrhaphia. Overall, 70% of the patients were postoperatively clinically and urodynamically continent at follow-up; however, only 44% of the patients with a preoperative urethra closure pressure (UCP) less than 20 cm H2O were continent. The functional urethral length was unchanged but the point of maximum closure pressure was shifted to the proximal third of the urethra. The UCP at rest decreased significantly (p = 0.0277). Radiologically, the bladder neck was elevated further and the angle beta decreased more in the patients continent after surgery, than in those who remained incontinent. These data suggest that the Stamey operation is effective in selected patients with stress incontinence, but not in patients with a low UCP at rest.

Sixty-six patients who underwent radical abdominal hysterectomy between 1971 and 1985 for stage Ib-IIb cervical cancer underwent urodynamic studies 1-15 years after surgery. None of the patients had received radiotherapy. Surgical specimens were processed as serial giant sections permitting measurement of the resected parametrial and paravaginal tissue. In 1984 parametrial resection was extended to the pelvic wall by the use of hemoclips. Impaired bladder sensation, bacteriuria, and residual urine were significantly more common among the patients who had more radical surgery, as were reduced flow rates and abnormal bladder compliance.

We performed urologic evaluations and urodynamic studies on 40 patients before and 2 weeks, 6 months and 1 year after radical abdominal hysterectomy for cervical cancer. Preoperative findings were mostly within normal limits. Fourteen days after surgery, all patients had small, spastic bladders and 68% had residual urine. Bladder sensation was impaired in all patients at 2 weeks and in 63% after 1 year. The average bladder capacity was 400 ml before surgery, 180 ml at 2 weeks, 350 ml at 6 months, and 460 ml at 1 year. One year postoperatively, no patient had residual urine, but 17.5% had asymptomatic bacteriuria, 17.5% had bladder trabeculation, 62.5% had abnormal compliance, and 85% used abdominal straining to void. Three patients developed overflow incontinence and 8 women developed urodynamic stress incontinence. Most patients were tolerant of the observed dysfunction.

184 women who underwent surgery because of stress incontinence during the years 1982-1986 were examined both before and after surgery. The interval between operation and post operational control was from 12 to 60 months. After colporrhaphy anterior and colcoperineoplasty 69% of the women were continent; 14% showed a stress incontinence of first degree, 17% a stress incontinence of second degree. After Marshall-Marchetti 75% of the patients were continent; 16% were stress incontinent to degree I. The best result was achieved by lifting the neck of the bladder (Stamey-method): 82% of the women were continent, 18% stress incontinent. The urethral closure pressure at rest went down significantly after colporrhaphia anterior; it rose slightly after Marshall-Marchetti and the endoscopic lifting of the bladder neck (Stamey-method). All postoperatively continent women showed an improval of pressure transmission, the best result having been achieved after the endoscopic lifting of the bladder neck (Stamey-method). Contrary to colporrhaphia anterior and colpoperineoplasty the miction was impaired after abdominal operational methods. The results will be shown and discussed.

OBJECTIVE: The current study aimed to evaluate objective and subjective results 10 years after the tension-free vaginal tape procedure. STUDY DESIGN: Two hundred ten patients who underwent a tension-free vaginal tape procedure at the 2 participating units between 1999 and 2001 were invited for follow-up. Evaluation at 10 years included history, clinical examination, cystoscopy, urodynamics, a cough stress test, and the Incontinence Outcome Questionnaire. RESULTS: Interview data were available for 67%; full clinical investigation was performed in 56% of patients. At 10 years, the clinical stress test was negative in 84%, slightly positive in 8.5%, and strongly positive in 4.3%. Subjectively, 57% of patients considered themselves 'cured,' 23% 'improved,' 6.4% 'unchanged,' and 11% 'worse.' Eleven of 141 (7.8%) had been reoperated in the interim. The rate of de novo urgency was 20%. Obesity seemed to be a risk factor for failure. CONCLUSION: These data indicate satisfactory objective and subjective cure rates 10 years after tension-free vaginal tape procedure placement. [ABSTRACT FROM AUTHOR]