Re: SUI after sacrocolpopexy
From: Joe Cutchin (forcep@intercom.net)
Mon Nov 6 08:56:53 2006
Glen: I see it as a failure of the MM procedure which is not unusual. I
would wait another month or two and offer TVT . Curious only. What did
you use for graft and how did you attach to sacrum? Joe C
Elrod, Darryl G Maj 48 MDOS/SGOBO wrote:
> I did my first abdominal sacrocolpopexy post residency now 5 weeks ago
> for symptomatic vaginal prolapse after a hysterectomy. The pt also had
> symptoms of stress incontinence and what I felt to be a paravaginal
> defect cystocele. I did an abdominal sacrocolpopexy, abdominal
> paravaginal repair, Burch and a posterior repair. I did cystoscopy
> after completing the Burch. Her postop course was uneventful. She had
> the catheter out the next morning and was discharged later that
> afternoon after she spontaneously voided and her pain was controlled by
> Percocet.
>
> The only complication she has noticed since surgery is a much more
> pronounced symptoms of stress incontinence than prior to surgery. Now
> she has to do very little to cause leakage. Although the vagina looks
> very nicely supported, I have obviously changed the vaginal angle enough
> to promote incontinence rather than prevent it.
>
> At this point how would you guys (and gals) manage her? I think she is
> likely too close to her original surgery to consider a midurethral sling
> (TVT, TOT) but as I’ve not been in this position before I wouldn’t know.
>
> Thanks in advance,
>
> Glen
>
> //SIGNED//
>
> D. Glen Elrod, Maj., USAF, MC
>
> Obstetrician/Gynecologist
>
> Chief of Obstetrics
>
> 48 MDOS/SGOBO
>
> RAF Lakenheath, England
>
> Telephone DSN: 314-226-8130
>
> Comm: +44 (0) 1638 52 8130
>
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