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• W2009092103 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Female Urology1 May 2001A PROSPECTIVE EVALUATION OF THE EFFICIENCY OF EARLY POSTOPERATIVE BLADDER EMPTYING AFTER THE STAMEY PROCEDURE OR PUBOVAGINAL SLING FOR STRESS URINARY INCONTINENCE C.M. BRADY, I. AHMED, J. DRUMM, and H.D. FLOOD C.M. BRADYC.M. BRADY More articles by this author , I. AHMEDI. AHMED More articles by this author , J. DRUMMJ. DRUMM More articles by this author , and H.D. FLOODH.D. FLOOD More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66357-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The pubovaginal sling has been criticized as having a higher incidence of postoperative voiding dysfunction than other surgical approaches for the management of stress urinary incontinence. In 2 similar patient groups we prospectively compared the rates of early postoperative voiding dysfunction after the pubovaginal sling or Stamey procedure. Materials and Methods: Between June 1995 and January 1997, 50 consecutive patients underwent the pubovaginal sling or Stamey procedure. Emptying efficiency was measured 48 hours postoperatively by suprapubic catheter in the Stamey group and intermittent catheterization in the pubovaginal sling group. When emptying efficiency was greater than 75%, intermittent catheterization was stopped or the suprapubic catheter was removed. Results: There was no statistically significant difference in emptying efficiency for the first 3 voids using the Dunn multiple comparison method. Median voiding efficiencies were 37%, 43% and 61% with the Stamey procedure in group 1 (mean 43%, 45% and 54%), and 60%, 75% and 75% with the pubovaginal sling in group 2 (mean 49%, 68% and 69%), respectively. The mean number of intermittent catheterizations performed in patients with the pubovaginal sling was 5.7 in less than 1 day. In the Stamey group the suprapubic catheter was removed an average of 6 days postoperatively. The mean duration of hospital stay was similar for the sling and Stamey groups (5.4 versus 6 days, respectively). There were 2 patients in each group who were voiding inefficiently after day 7. Voiding efficiency was restored at 53 and 86 days in the 2 patients with slings and at 18 days in 1 of the 2 who underwent the Stamey procedure, respectively. The second patient who underwent the Stamey procedure was able to void without using the catheter at all, and it was removed 30 days postoperatively when emptying efficiency was confirmed greater than 75%. Conclusions: These data show that early postoperative voiding dysfunction, measured using bladder emptying efficiency, after the pubovaginal sling is no more common than after the Stamey procedure and help justify the broadened indications for pubovaginal sling for treatment of stress urinary incontinence. References 1 : Pubovaginal sling procedure for stress incontinence. J Urol1978; 119: 82. Link, Google Scholar 2 : Expanded indications for the pubovaginal sling: treatment of type 2 or 3 stress incontinence. J Urol1996; 156: 1620. Link, Google Scholar 3 : Treatment of stress urinary incontinence in women with urethral hypermobility and intrinsic sphincter deficiency. J Urol1996; 156: 1995. Link, Google Scholar 4 : Treatment results using pubovaginal slings in patients with large cystoceles and stress incontinence. J Urol1997; 158: 431. Link, Google Scholar 5 : Pubovaginal sling for treatment of female stress urinary incontinence complicated by urethral diverticulum. J Urol1993; 149: 1012. Link, Google Scholar 6 : Pubovaginal fascial sling for the treatment of complicated stress urinary incontinence. J Urol1991; 145: 1214. Link, Google Scholar 7 : Favorable outcome of pubovaginal slings for geriatric women with stress incontinence. J Urol1997; 157: 125. Link, Google Scholar 8 : Our experience with pubovaginal slings in patients with stress urinary incontinence. J Urol1998; 159: 1195. Link, Google Scholar 9 : The effectiveness of surgery for stress incontinence in women: a systematic review. Br J Urol1996; 78: 497. Google Scholar 10 : Burch colposuspension: 10–20 year follow up. Br J Obstet Gynaecol1995; 102: 740. Google Scholar 11 : Four decades of needle bladder neck suspension. Br J Urol1998; 82: 171. Google Scholar 12 : A followup on transurethral collagen injection therapy for urinary incontinence. J Urol1998; 159: 106. Link, Google Scholar 13 : The pathophysiology of stress urinary incontinence in women and its implications for surgical treatment. World J Urol1997; 15: 268. Google Scholar 14 : Endoscopic suspension of the vesical neck for urinary incontinence. Surg Gynecol Obstet1973; 136: 547. Google Scholar 15 : Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary incontinence. The American Urological Association. J Urol1997; 158: 875. Link, Google Scholar 16 : Transvaginal needle suspension operation: the way we do it. Clinical and urodynamic study: long-term results. Eur Urol2000; 37: 325. Google Scholar 17 : Retropubic cystourethropexy: is it an obstructive procedure?. J Urol1997; 158: 533. Link, Google Scholar 18 : Voiding after Burch colposuspension and effects of concomitant pelvic surgery: correlation with preoperative voiding mechanism. Obstet Gynecol1996; 88: 564. Google Scholar 19 : Early voiding difficulty after colposuspension. Br J Urol1997; 80: 911. Google Scholar 20 : The influence of sling tension on the outcome of pubovaginal sling surgery for stress urinary incontinence. Br J Urol1998; 81: 65. Google Scholar 21 : Quantifying thread tension is of clinical use in Stamey bladder neck suspension: analysis of clinical parameters. J Urol1989; 141: 38. Link, Google Scholar 22 : Suburethral sling procedure for urinary stress incontinence. With special reference to determination of tension of suspension from posturethrovesical angle measured by ultrasonography. Nippon Hinyokika Gakkai Zasshi1990; 81: 1351. Google Scholar 23 : A simple objective method of adjusting sling tension. J Urol1999; 162: 1674. Abstract, Google Scholar From the Department of Urology, Limerick Regional Hospital, Limerick, Ireland© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byGiri S, Hickey J, Sil D, Mabadeje O, Shaikh F, Narasimhulu G and Flood H (2018) The Long-Term Results of Pubovaginal Sling Surgery Using Acellular Cross-Linked Porcine Dermis in the Treatment of Urodynamic Stress IncontinenceJournal of Urology, VOL. 175, NO. 5, (1788-1793), Online publication date: 1-May-2006. Volume 165Issue 5May 2001Page: 1601-1604 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsurinary catheterizationurinationbladderurinary incontinenceMetricsAuthor Information C.M. BRADY More articles by this author I. AHMED More articles by this author J. DRUMM More articles by this author H.D. FLOOD More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2009092103 title "A PROSPECTIVE EVALUATION OF THE EFFICIENCY OF EARLY POSTOPERATIVE BLADDER EMPTYING AFTER THE STAMEY PROCEDURE OR PUBOVAGINAL SLING FOR STRESS URINARY INCONTINENCE" @default.
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