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Very long-term follow-up of the anterior vaginal wall suspension procedure for incontinence and/or prolapse repair

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Abstract

Objective

To report outcomes of the anterior vaginal wall suspension (AVWS) procedure for stress urinary incontinence (SUI) and/or anterior compartment prolapse (POP), with minimum 10-year follow-up.

Methods

Following institutional review board approval, a database of patients with > 10-year follow-up after AVWS for bothersome SUI with early stage anterior compartment prolapse (stage ≤ 2) or symptomatic anterior compartment prolapse (stage > 2) was reviewed. Preoperative evaluation included validated questionnaires [Urogenital Distress Inventory-Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), quality of life (QoL)], Pelvic Organ Prolapse Quantification (POP-Q), and voiding cystourethrography. Follow-up data was based on clinic visits or telephone interviews for patients not seen in the past 2 years. Telephone interviews used validated questionnaires and were conducted by a third party not involved in patient care. Failure was defined as reoperation for SUI or POP. The influence of lost to follow-up (LTF) was also analyzed.

Results

Between 1996 and 2008, 161 of 328 patients met study criteria, with follow-up from phone interviews (103) or clinic visits (58). The LTF patients were deceased (52), mentally disabled (5), or unreachable by telephone (110). Median follow-up was 13.5 years (IQR 11.5–17). Type of follow-up (clinic vs. phone) and uterine status (concomitant/prior/no hysterectomy) did not impact reoperation rates. Reoperation occurred in 23/161 (14%) and consisted of sacrocolpopexy (8), anterior colporrhaphy (5), injectable agents (8), fascial sling (2).

Conclusions

The AVWS procedure to restore anterior vaginal support to the bladder neck and bladder base to correct SUI/POP can provide satisfactory and durable results.

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Abbreviations

AVWS:

Anterior vaginal wall suspension

SUI:

Stress urinary incontinence

POP:

Pelvic organ prolapse

UDI-6:

Urogenital distress inventory-short form

IIQ-7:

Incontinence impact questionnaire-short form (IIQ-7)

QoL:

Quality of life

POP-Q:

Pelvic organ prolapse quantification

VCUG:

Voiding cystourethrography

IQR:

Interquartile range

CI:

Confidence Interval

FA:

Feras Alhalabi

AK:

Amy Kuprasertkul

LTF:

Lost to follow-up

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Authors and Affiliations

  1. UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75309, USA

    Amy Kuprasertkul, Alana L. Christie, Feras Alhalabi & Philippe Zimmern

Authors
  1. Amy Kuprasertkul
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  2. Alana L. Christie
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  3. Feras Alhalabi
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  4. Philippe Zimmern
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Contributions

AK: project development, data collection, manuscript writing/editing. AC: data analysis. FA: data collection/management. PZ: project development, manuscript writing/editing.

Corresponding author

Correspondence to Philippe Zimmern.

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The authors declare that they have no conflict of interest.

Research involving human participants and/or animals, ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional research committee (UT Southwestern IRB) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kuprasertkul, A., Christie, A.L., Alhalabi, F. et al. Very long-term follow-up of the anterior vaginal wall suspension procedure for incontinence and/or prolapse repair. World J Urol 39, 533–542 (2021). https://doi.org/10.1007/s00345-020-03190-3

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  • DOI: https://doi.org/10.1007/s00345-020-03190-3

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