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[Impact of rectal prolapse and rectocele on TVT results]
Marouane Ben Amna1, Philippe Grise, Francis Michot
1Service d'Urologie, Hôpital Charles Nicolle, 1, rue de Germont, 76031 Rouen.
Objectives:
The comorbidity between rectal repair surgery and stress urinary incontinence (SUI) repair by TVT (simplified suburethral sling procedure) is a poorly defined entity. The objective of this study was to evaluate the influence of this combination on the quality of postoperative voiding and urinary continence.
Methods:
Retrospective analysis of 12 patients (group 1) simultaneously treated by TVT and rectocele repair by anterior rectal mucosectomy (Sullivan: 6 cases) or rectal prolapse repair (open rectal fixation: 6 cases). They were compared to a group of 12 randomly selected patients (group 2) treated by TVT alone during the same period.
Results:
A significant post-voiding residual urine volume was observed in 4 women of group 1 versus only one woman of group 2. All patients subsequently and spontaneously resumed satisfactory voiding except for one woman of group 1, in whom self-catheterization had to be maintained. After a mean follow-up of 18 months for group 1 and 17 months for group 2, only one woman, in group 2, was still incontinent.
Conclusion:
Rectal repair surgery, combined with TVT, increases the risk of transient postoperative urinary retention. This surgical combination does not appear to modify the medium-term result of the urological procedure.