Is It Necessary to Repair Grade 2 Cystocele Combined with Stress Urinary Incontinence for Better Urinary Symptoms?
Dr Dong Youp Han (1), Dr Kwang Mo Kim (2)
(1) urology, Gunsan Med. Ctr., Gunsan City, Korea, Republic Of,, Gun San City, South Korea, (2) urology, Gunsan Med. Ctr., Gunsan City, Korea, Gun San City, South Korea
Surgical treatment of Grade 2 cystocele combined with stress urinary incontinence (SUI) has been controversy until now. So we investigated patient’s urinary symptoms after surgical treatment of grade 2 cystocele combined with SUI using questionnaires and voiding diary.
From January 2010 to December 2013, 69 patients with grade 2 cystocele combined with SUI were enrolled. They were divided into two groups according to the surgery type; only sling operation (Group A, n=44) and sling operation + cystocele repair (Group B, n=25). Patients were conducted preoperative physical examination, urodynamic study, questionnaires (ICIQ-SF, ICIQ-OAB) and three day voiding diary. Three months postoperatively, physical examination, questionnaires (ICIQ-SF, ICIQ-OAB) and three day voiding diary of patients were reevaluated.
There were no significant differences between groups for the preoperative questionnaires (ICIQ-SF/ICIQ-OAB), voided volume, number of voiding, functional bladder capacity and the postoperative ICIQ-SF (table 1, 2). Significant differences were observed between groups A and B with respect to the postoperative ICIQ-OAB (8.84±1.06 vs. 6.53±0.54, P=0.021) and the actual number of nightly voids (1.65±0.90 vs. 0.94±0.78, P=0.042)(Table 2). The functional bladder capacity significantly increased (255.5±±79.4 vs. 307.6±98.4, P=0.017) in Group B (Table 2).
To repair grade 2 cystocele combined with SUI is beneficial because it decreases the overactive bladder symptoms and the actual number of nightly voids and increases the functional bladder capacity.