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Utilizing preoperative 20-minute pad testing with vaginal gauze packing for indicating concomitant midurethral sling during cystocele repair.

Eur J Obstet Gynecol Reprod Biol. 2014 Jan;172:127-30. doi: 10.1016/j.ejogrb.2013.10.008. Epub 2013 Oct 12.

Chang TC1, Hsiao SM2, Chen CH1, Wu WY2, Lin HH3.
Author information 1Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.2Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.3Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan. Electronic address: hhlin@ntuh.gov.tw.
Eur J Obstet Gynecol Reprod Biol
ABSTRACT
OBJECTIVE: To investigate the feasibility of using preoperative 20-minute pad testing with vaginal gauze packing for cystocele reduction to indicate a concomitant midurethral sling during cystocele repair.STUDY DESIGN: Retrospective review of the records of consecutive women with pelvic organ prolapse quantification=stage II symptomatic cystocele who visited the urogynecologic outpatient clinics and underwent cystocele repair between July 2005 and December 2010. Only patients who underwent preoperative urodynamic studies and 20-minute pad testing with vaginal gauze packing for cystocele reduction were enrolled.RESULTS: Twenty-one patients did not demonstrate any stress urinary incontinence. For evident stress urinary incontinence (>1g pad weight before reduction), the criterion of =8g pad weight before reduction was chosen for concomitant midurethral sling. For patients with occult stress urinary incontinence (=1g pad weight before reduction), the criterion of =8g pad weight after reduction was chosen as an indication for concomitant midurethral sling. Among 22 patients with evident stress urinary incontinence (<8g) without concomitant midurethral sling, only one patient (4.5%) received a midurethral sling during the follow-up period (median follow-up interval: 30.5 months). Among 21 patients with occult stress incontinence but <8g after reduction without concomitant midurethral sling, only one patient (4.8%) received midurethral sling during the follow-up period (median follow-up interval: 38 months).CONCLUSIONS: A preoperative 20-minute pad test with vaginal gauze packing for cystocele reduction is a feasible and practical method to decide for a concomitant midurethral sling.Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:24183347 | http://www.ncbi.nlm.nih.gov/pubmed/24183347

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