Outcome of rolled fortified vaginal flap operation on female patients with intrinsic sphincteric deficiency: 2-year follow-up

Int Urogynecol J. 2019 Mar;30(3):393-399. doi: 10.1007/s00192-018-3621-7. Epub 2018 Mar 28.

Abstract

Introduction and hypothesis: We evaluate the 2-year outcome of the rolled fortified vaginal flap (RFVF) operation for the treatment of stress urinary incontinence (SUI) due to intrinsic sphincteric deficiency (ISD).

Methods: A prospective study of 20 women suffering from SUI due to ISD was conducted. All patients were subjected to history-taking, clinical examination, cough stress test, and urodynamics. Symptom severity and quality of life (QoL) were assessed using the Arabic version of the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF). All studied women were followed up for 24 months to detect success rate, any postoperative complications, and reveal changes in the quality of life.

Results: Mean age was 53 ± 8 years. Preoperative Valsalva leak point pressure was 50.1 ± 11.3 cmH2O. After a follow-up period of 24 months, only 2 patients (10%) showed mild stress incontinence with mean VLPP 80± 3 cm H2O. Postoperative mean maximum flow rate (Q-max) and mean Pdet-Qmax showed no significant difference from the preoperative results (P = 0.115 and 0.187 respectively). The quality of life domain of the ICIQ-UI-SF decreased significantly from 73.5 ± 12.1% (preoperatively) to 2.6 ± 8.1% (after a 1-year follow-up), P < 0.001 and then showed a slight increase to 4.5 ± 10.6 at 24 months' follow-up.

Conclusion: The RFVF operation has a success rate of 90% after a 24-month follow-up. It significantly improved the quality of life of women with SUI due to ISD.

Keywords: Quality of life; Rolled fortified vaginal flap; Stress urinary incontinence; Urodynamics.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Pressure
  • Prospective Studies
  • Quality of Life
  • Severity of Illness Index
  • Surgical Flaps*
  • Surveys and Questionnaires
  • Urethra / physiopathology*
  • Urethra / surgery*
  • Urinary Incontinence, Stress / surgery*
  • Urodynamics
  • Vagina / surgery*
  • Valsalva Maneuver