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Any change of bladder function after pelvic floor reconstruction surgery?
( Tsung-hsien Su ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
Pelvic organ prolapse (POP) is becoming a common problem as life expectancy increases and the global population ages. Genital prolapse is associated with various lower urinary tract symptoms, particularly stress urinary incontinence (SUI). Concomitant SUI in patients with prolapse is reported to be as high as 63 % [1], while occult SUI, defined as urine leakage after prolapse reduction, is reported to be 36-80 % in continent women with POP [2,3], while 28-33 % of women who are asymptomatic for SUI before prolapse repair develop de novo SUI after mesh repairs [4,5]. To treat concomitant or occult SUI and prevent de novo SUI, anti-incontinence surgery is often undertaken simultaneously with prolapse repair surgery. However, concomitant anti-incontinence surgery is still debatable and not universally performed, because it carries risks and may not benefit all patients. On the other hand, several studies have reported the successful treatment of both prolapse and stress incontinence by vaginal mesh repair surgery only, without an additional sub-urethral sling [6,7]. A trans-obturator sub-vesical mesh is similar to that of a trans-obturator sling, creating a hammock under the proximal urethra to cure not only the prolapse but also the stress incontinence. Is there any standard strategy in performing concomitant anti-incontinence surgery with prolapse repair? The topic today is to present the impact of POP surgery on bladder function, including stress urinary incontinence, detrusor overactivity, and voiding dysfunction.