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Preoperative maximum urethral closure pressure and valsalva leak point pressure as predictive parameters for midurethral sling

Authors
 Hyun Joo Jung  ;  Ga Won Yim  ;  Myung Jae Jeon  ;  Sei Kwang Kim  ;  Sang Wook Bai 
Citation
 JOURNAL OF REPRODUCTIVE MEDICINE, Vol.54(7) : 436-440, 2009 
Journal Title
JOURNAL OF REPRODUCTIVE MEDICINE
ISSN
 0024-7758 
Issue Date
2009
MeSH
Aged ; Chi-Square Distribution ; Female ; Humans ; Hydrostatic Pressure ; Middle Aged ; Postoperative Complications* ; Prosthesis Implantation/adverse effects* ; ROC Curve ; Reference Values ; Suburethral Slings* ; Treatment Outcome ; Urethra/surgery* ; Urinary Incontinence, Stress/surgery* ; Urodynamics* '
Keywords
stress urinary incontinence ; tension-free vaginal tape ; transobturator tape ; urethral closure pressure ; Valsalva leak point pressure
Abstract
OBJECTIVE: To evaluate the efficacy of tension-free vaginal tape (TVT) and transobturator tape (TOT) according to urethral function based on a preoperative urodynamic study (UDS).

STUDY DESIGN: Preoperative Valsalva leak point pressure (VLPP) and maximum urethral closure pressure (MUCP) were compared with the actual surgical outcome, and patients were followed for > 1 year. Student's t test, chi2 test, multiple regression analysis and receiver operating character curve analysis were used for statistical analysis. Of the 437 patients, 225 received TVT and 212 patients received TOT.

RESULTS: Age, parity, body mass index, menopausal status, hormone replacement therapy and previous surgical history showed no significant difference between the groups. Advanced pelvic organ prolapse, concomitant hysterectomy and vault suspension were more common in the TOT group, whereas concomitant anterior colporrhaphy was more common in the TVT group. The treatment outcome of TVT was not associated with VLPP and MUCP. However, cutoff values of VLPP > or = 72.5 cm H2O and MUPC > or = 42 cm H2O were most predictive of successful surgical outcomes in TOT group, revealing a sensitivity of 95.7% and a positive predictive value of 98.4%.

CONCLUSION: Preoperative MUCP and VLPP can predict the treatment outcome of TOT but not TVT.
Full Text
http://www.reproductivemedicine.com/toc/auto_abstract.php?id=23639
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sei Kwang(김세광)
Bai, Sang Wook(배상욱) ORCID logo https://orcid.org/0000-0001-7724-7552
Yim, Ga Won(임가원)
Jeon, Myung Jae(전명재)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104931
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