Combined treatment with vaginal native tissue repair plus mid-urethral sling or pelvic floor muscle training in patients with anterior defect and occult stress urinary incontinence: quality of life and sexual function analysis

Debora Grilli; Melania Loggia; Federica Sala; Pier L Palazzetti; Marzio A Zullo; Paolo Luffarelli; Vincenzo Spina; Herbert C Valensise; Michele C Schiavi

doi:10.23736/S2724-606X.23.05289-2

Combined treatment with vaginal native tissue repair plus mid-urethral sling or pelvic floor muscle training in patients with anterior defect and occult stress urinary incontinence: quality of life and sexual function analysis

Minerva Obstet Gynecol. 2023 Jun 7. doi: 10.23736/S2724-606X.23.05289-2. Online ahead of print.

Authors

Debora Grilli^{1

2}, Melania Loggia^{3

2}, Federica Sala^{1

2}, Pier L Palazzetti¹, Marzio A Zullo⁴, Paolo Luffarelli⁴, Vincenzo Spina⁵, Herbert C Valensise^{2

6}, Michele C Schiavi¹

Affiliations

¹ Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy.
² Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy.
³ Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy - melaloggia1@gmail.com.
⁴ Department of Surgery-Week Surgery, Campus Biomedico University, Rome, Italy.
⁵ Unit of Protection of Maternal and Child Health, Rieti, Italy.
⁶ Department of Obstetrics and Gynecology, Casilino Hospital, Rome, Italy.

PMID: 37283533
DOI: 10.23736/S2724-606X.23.05289-2

Abstract

Background: The aim of this study was to compare the efficacy of vaginal native tissue repair (VNTR) combined with tension-free transobturator tape (TVT-O) or pelvic floor muscle training (PFMT) in terms of quality of life (QoL) and sexual function (SF) in women affected by anterior defect and occult stress urinary incontinence (OSUI).

Methods: One hundred forty-seven patients with symptomatic anterior defect with OSUI underwent VNTR. In 71 patients TVT-O was inserted and 76 underwent PFMT after surgery. Clinical exam, 3-day voiding diary and urodynamic testing were evaluated in preoperative and postoperative times. Specific questionnaires were also administered, in order to indagate disease perception and the impact on QoL and SF.

Results: Nine patients had postoperative pain in the TVT-O group vs. 0 patients in the PMFT group (P=0.001) and 7 patients reported de novo urgency vs. 3 in the two groups, respectively. At 12 weeks follow-up (FU), the first voiding desire was at 88.12+19.70 mL in VNTR+TOT vs. 102.29+19.13 (P=0.03); the mean number of voids (24 hours) was 9.95±2.66 vs. 6.14±1.77 (P=0.04), respectively. No significant differences in terms of QoL and SF were shown.

Conclusions: This retrospective study suggests that VNTR+TVT-O and VNTR+PMFT have the same efficacy in terms of QoL and SF, with several post-operative complications, even if minor, in patients treated with combined surgery.