E-Posters-Efficacy of Periurethral Bulking Agents in Management of Stress Urinary Incontinence after Transvaginal Tape (TVT) Failure Following Combined Robotic Sacrocolpopexy and TVT

Efficacy of Periurethral Bulking Agents in Management of Stress Urinary Incontinence after Transvaginal Tape (TVT) Failure Following Combined Robotic Sacrocolpopexy and TVT - Jihad M Harmouche, MD

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This study examines the efficacy of periurethral bulking agents in managing stress urinary incontinence (SUI) after transvaginal taping (TVT) failure following combined robotic sacrocolpopexy and TVT procedures. The study was conducted at Ascension St. John Hospital in Detroit, Michigan.<br /><br />The chart review included adult patients who underwent periurethral bulking agent treatment after TVT failed to resolve SUI. The success of the treatment was measured by the absence of SUI symptoms at three months postoperative. Failure was defined as continued stress urinary incontinence.<br /><br />By age 60, more than one-third of women have pelvic floor disorders, and concomitant pelvic organ prolapse (POP) and SUI may be seen in as many as 63% of patients with pelvic floor dysfunction. Previous trials have shown reduced postoperative incontinence rates when Burch colposuspension or midurethral sling procedures were performed at the time of prolapse surgery. However, there has been no research on the use of periurethral bulking agents as a corrective treatment for SUI following TVT failure after combined sacrocolpopexy and TVT procedures.<br /><br />The results of this study showed that out of 98 patients who underwent TVT at the time of sacrocolpopexy, 12 patients (12.2%) continued to have SUI. Ten of these patients underwent treatment with a periurethral bulking agent, with eight patients experiencing complete resolution of SUI at three months post-treatment.<br /><br />The study concludes that periurethral bulking agents could be an option for treating patients who continue to have SUI after TVT failure at the time of sacrocolpopexy. These agents may be particularly useful for patients with multiple comorbidities who are not considered good surgical candidates. The study demonstrated an 80% success rate with this minimally invasive approach.<br /><br />In summary, periurethral bulking agents show promise as a treatment option for managing SUI after TVT failure following combined sacrocolpopexy and TVT procedures. Further research is needed to confirm these findings and determine the long-term effectiveness of this treatment approach.

Keywords

periurethral bulking agents

stress urinary incontinence

transvaginal taping

TVT failure

robotic sacrocolpopexy

pelvic floor disorders

pelvic organ prolapse

Burch colposuspension

midurethral sling procedures

minimally invasive approach