Objective
Study Design
Results
Conclusion
Key words
Methods
Results
Variable | Abnormal cystoscopy because of injury (n = 72) | Abnormal cystoscopy not because of injury (n = 23) | Total subjects undergoing antiincontinence procedure, n |
---|---|---|---|
Autologous pubovaginal sling | 6 | 6 | 347 |
Burch retropubic urethropexy | 21 | 3 | 329 |
Retropubic midurethral sling | 43 | 10 | 676 |
Transobturator midurethral sling | 2 | 4 | 460 |
Other | 0 | 0 | 18 |
Total | 1830 |
Characteristic | Autologous pubovaginal sling | Retropubic urethropexy | Retropubic midurethral sling | Transobturator midurethral sling | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Injured (n = 6) | Uninjured (n = 341) | P value | Injured (n = 21) | Uninjured (n = 308) | P value | Injured (n = 43) | Uninjured (n = 633) | P value | Injured (n = 2) | Uninjured (n = 458) | P value | |
Age, y | 62.9 ± 12.0 | 51.4 ± 9.9 | .02 | 56.9 ± 10.3 | 51.9 ± 10.5 | .04 | 52.8 ± 11.6 | 52.0 ± 10.5 | .55 | 54.0 ± 6.0 | 52.2 ± 10.8 | .66 |
Body mass index, kg/m2 | 26.5 ± 4.6 | 30.3 ± 6.1 | .13 | 32.2 ± 7.3 | 29.6 ± 6.0 | .06 | 28.6 ± 6.5 | 29.7 ± 6.5 | .18 | 27.7 ± 4.9 | 29.8 ± 6.2 | .65 |
Parity, n | 2.7 ± 1.8 | 3.3 ± 1.7 | .42 | 3.6 ± 1.4 | 3.3 ± 1.8 | .23 | 3.0 ± 1.8 | 2.9 ± 1.6 | .86 | 2.5 ± 0.7 | 3.1 ± 1.7 | .59 |
Vaginal deliveries, n | 2.2 ± 1.3 | 2.5 ± 1.5 | .60 | 3.1 ± 1.0 | 2.6 ± 1.6 | .04 | 2.3 ± 1.2 | 2.1 ± 1.3 | .24 | 2.5 ± 0.7 | 2.3 ± 1.4 | .71 |
Hormone therapy/ menopausal status, n (%) | ||||||||||||
No | 4 (66.7) | 112 (33.5) | .17 | 8 (38.1) | 109 (35.4) | .26 | 11 (32.4) | 117 (24.1) | .52 | 1 (50.0) | 115 (29.8) | > .99 |
Yes | 2 (33.3) | 111 (33.2) | 10 (47.6) | 107 (34.7) | 10 (29.4) | 145 (29.8) | 0 | 110 (28.5) | ||||
Premenopausal | 0 | 111 (33.2) | 3 (14.3) | 92 (29.9) | 13 (38.2) | 224 (46.1) | 1 (50.0) | 161 (41.7) | ||||
Smoking status, n (%) | ||||||||||||
Never | 1 (16.7) | 173 (50.7) | .04 | 15 (71.4) | 179 (58.1) | .19 | 26 (60.5) | 367 (58.0) | .54 | 2 (100) | 269 (58.7) | .64 |
Former | 5 (83.3) | 112 (32.8) | 6 (28.6) | 90 (29.2) | 14 (32.5) | 183 (28.9) | 0 | 140 (30.6) | ||||
Current | 0 | 56 (16.4) | 0 | 39 (12.7) | 3 (7.0) | 83 (13.1) | 0 | 49 (10.7) | ||||
Stage of prolapse, n (%) | ||||||||||||
Stage 0 & 1 | 1 (20.0) | 75 (23.4) | > .99 | 10 (47.6) | 75 (24.3) | .06 | 7 (46.7) | 123 (43.5) | .13 | 1 (100) | 136 (45.6) | .54 |
Stage 2 | 3 (60.0) | 189 (59.1) | 10 (47.6) | 185 (60.1) | 5 (33.3) | 139 (49.1) | 0 | 138 (46.3) | ||||
Stage 3 & 4 | 1 (20.0) | 56 (17.5) | 1 (4.8) | 48 (15.6) | 3 (20.0) | 21 (7.4) | 0 | 24 (8.1) | ||||
Medical, Epidemiological, and Social aspects of Aging questionnaire urge index at baseline, % | 33.2 ± 30.7 | 35.4 ± 21.8 | .80 | 42.8 ± 19.9 | 36.1 ± 21.8 | .11 | 34.7 ± 25.0 | 33.0 ± 21.5 | .86 | 27.5 ± 7.8 | 34.2 ± 22.2 | .71 |
Any urinary incontinence surgery, n (%) | 1 (20.0) | 42 (13.1) | .51 | 6 (28.6) | 44 (14.3) | .11 | 3 (20.0) | 35 (12.4) | .42 | 0 | 41 (13.8) | > .99 |
Previous urinary incontinence surgery, n (%) | ||||||||||||
1 | 1 (100.0) | 35 (83.3) | > .99 | 6 (100.0) | 33 (75.0) | .67 | 3 (100.0) | 28 (80.0) | > .99 | 0 | 33 (80.5) | Not available |
2 | 0 | 6 (14.3) | 0 | 9 (20.4) | 0 | 5 (14.3) | 0 | 8 (19.5) | ||||
3 | 0 | 1 (2.4) | 0 | 2 (4.6) | 0 | 1 (2.9) | — | — | ||||
4 | — | — | — | — | 0 | 1 (2.9) | — | — | ||||
Previous Burch, n (%) | 0 | 4 (1.2) | > .99 | 0 | 1 (0.3) | > .99 | 2 (13.3) | 7 (2.5) | .07 | 0 | 7 (2.3) | > .99 |
Previous sling, n (%) | 1 (20.0) | 6 (1.9) | .10 | 0 | 8 (2.6) | > .99 | 1 (6.7) | 8 (2.8) | .38 | 0 | 6 (2.0) | > .99 |
Previous cesarean delivery, n (%) | 0 | 40 (11.7) | > .99 | 0 | 33 (10.7) | .25 | 7 (16.3) | 83 (13.1) | .49 | 0 | 69 (15.0) | > .99 |
Anesthesia, n (%) | ||||||||||||
General | 3 (60.0) | 251 (78.4) | .30 | 16 (76.2) | 261 (84.7) | .35 | 12 (80.0) | 202 (71.4) | .57 | 1 (100) | 212 (71.1) | > .99 |
Spinal/epidural | 2 (40.0) | 79 (24.7) | .60 | 7 (33.3) | 55 (17.9) | .09 | 1 (6.7) | 17 (6.0) | > .99 | 0 | 19 (6.4) | > .99 |
Sedation/local | — | — | — | — | 3 (4.5) | 64 (95.5) | > .99 | 0 | 69 (23.2) | > .99 | ||
Estimated blood loss, mL | 175 ± 185 | 239 ± 319 | .44 | 393 ± 521 | 218 ± 317 | .01 | 87 ± 100 | 76 ± 118 | .43 | 200 ± – | 67 ± 124 | .13 |
Concomitant surgery, n (%) | 2 (33.3) | 197 (57.8) | .41 | 9 (42.9) | 175 (56.8) | .26 | 8 (18.6) | 133 (21.0) | .85 | 0 | 98 (21.4) | > .99 |
Surgeon experience fellow assistance, n (%) | 3 (50.0) | 132 (38.7) | .68 | 6 (28.6) | 110 (35.7) | .64 | 26 (60.5) | 461 (72.8) | .11 | 0 | 304 (66.4) | .11 |
Trocar injury | Type of voiding management at discharge, n (%) | |||
---|---|---|---|---|
Urethral catheter | CISC | Self-voiding | Total | |
No | 199 (18.5) | 61 (5.7) | 817 (75.9) | 1077 |
Yes | 25 (55.6) | 3 (6.7) | 17 (37.8) | 45 |
Total | 224 | 64 | 834 | 1122 |
Discussion
Appendix
SISTEr
Steering Committee
Co-investigators
Study Coordinators
Biostatistical Coordinating Center
Data Safety and Monitoring Board
TOMUS
Steering Committee
Co-investigators
Study Coordinators
Data Coordinating Center
Data Safety And Monitoring Board
ValUE
Steering Committee
Affiliated Sites
Co-investigators
Study Coordinators
Data Coordinating Center
Data Safety And Monitoring Board
References
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Article Info
Publication History
Footnotes
All members of the Urinary Incontinence Treatment Network are listed in the Appendix.
Supported by cooperative agreements ( U01 DK58225 , U01 DK58229 , U01 DK58234 , U01 DK58231 , U01 DK60379 , U01 DK60380 , U01 DK60393 , U01 DK60395 , U01 DK60397 , and U01 DK60401 ) from the National Institute of Diabetes and Digestive and Kidney Diseases and by the National Institute of Child Health and Human Development .
H.M.Z. and L.T.S. are consultants for Johnson & Johnson. The other authors report no conflict of interest.
Reprints not available from the authors.
Cite this article as: Zyczynski HM, Sirls LT, Greer WJ, et al. Findings of universal cystoscopy at incontinence surgery and their sequelae. Am J Obstet Gynecol 2014;210:480.e1-8.