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Is Preoperative Pelvic Floor Muscle Strength a Pre ...
Is Preoperative Pelvic Floor Muscle Strength a Predictor of Early Failure of Tension-Free Vaginal Tape Placement? - Douglas Timmons, MD, MPH
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This study aimed to determine if preoperative pelvic floor muscle strength (PFMS) is a predictor of early failure of tension-free vaginal tape placement in patients with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). The study included 91 patients who underwent the procedure, with 64 patients included in the final analysis. The patients were divided into two groups based on PFMS measurements.<br /><br />The overall failure rate for the procedure was 12.5% for the entire cohort, but only 2.6% in patients with isolated SUI. There was no significant difference in the continence outcome based on PFMS among patients with preoperative SUI. However, patients with MUI and weaker PFMS had a significantly higher recurrence rate of symptoms compared to those with stronger PFMS.<br /><br />The results suggest that PFMS does not impact the continence outcome in patients with preoperative SUI, but it is a significant factor in patients with MUI. Patients with weaker PFMS and MUI should be counseled about the higher risk for failure. Strengthening the pelvic floor muscles prior to surgery is important, especially in patients with MUI.<br /><br />The study also noted that while PFMS and midurethral sling placement are both effective options for patients with SUI, results for patients with MUI are not as promising. Patients with MUI as the indication for midurethral sling placement had a significantly higher rate of recurrence of symptoms compared to those with only SUI.<br /><br />In conclusion, preoperative PFMS is not a predictor of early failure of tension-free vaginal tape placement in patients with SUI. However, it is a significant factor in patients with MUI. Strengthening the pelvic floor muscles prior to surgery is important for patients with MUI. Further studies will explore the endurance of PFMS.
Keywords
preoperative pelvic floor muscle strength
tension-free vaginal tape placement
stress urinary incontinence
mixed urinary incontinence
failure rate
continence outcome
recurrence rate
symptoms
midurethral sling placement
pelvic floor muscles
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