Effectiveness Of TOT Procedure Combined With Modified Plevic Floor Reconstrution For Treatment Of Female Stress Urinary Incontinence Associated With Descensus Vaginae Anterior

ObjectiveTo compare the effectiveness and complications between TOT procedure combined with modified plevic floor reconstrution and combined with proliftTM anterior pelvic floor repair system for the treatment of female stress urinary incontinence associated with descensus vaginae anterior.MethodsWe analyzed the clinical information of71female patients (53in TOT and18in Prolift) in our hospital from September2008to May2013. These patients were confirmed stress urinary incontinence associated with descensus vaginae anterior With the patient consent to collect the basic information, including name, age, date of surgery, and home address, telephone number, etc, We collected the clinical characters and perioperative complications of all the patients. Measuring the urethrovesical angle, the lengths of B-PCL and U-PCL, the levator angle per and post-operation, All of the patients were asked to complete some validated questionnaires s Therapeutic effects were assessed by Grouts-Blaivas and POP-Q outcome score.The results of operations and complications were observed.ResultsThe results of patients in our hospital:①The mean value of operative time and hospital days in TOT group were lower than the Prolift group (P<0.05)②There was no significient difference in cure rate and improvement rate between the two groups (P>0.05).③The improvements of sexual satisfaction、the quality of life and social situation in TOT group were better than the Prolift group (P<0.05).④The occurrence rate of complications in thigh pain and mesh erosion in TOT group were lower than the Prolift group (P<0.05).There were no significient difference of the occurrence rates in urinary retention and micturition obstacles between the two groups (P>0.05).⑤Comparing with the preoperative patients, the pelvic organs were above PCL in the state of maximum force,the B-PCL length, the U-PCL length,the levator angle, the urethrovesical angle,the dynamic widths of levator hiatus in the postoperative patients of both groups were smaller than the preoperative patients (P<0.05).there are no significant difference between the two groups (P>0.05).Conclusion1.Our research shows analogical objective and subjective cure rates between the TOT procedure combined with modified plevic floor reconstrution and combined with proliftTM anterior pelvic floor repair system,both of the surgical approaches can restore and maintain the normal position of pelvic organs and functions.2.The modified plevic floor reconstrution can significient improve the quality of life for patients who have diagnosed of SUI associated with descensus vaginae anterior.3. The modified plevic floor reconstrution is associated with a lower risk of several complications.The procedure is simple, less complications and more affordable.