TRANSOBTURATOR SURGERY IS A SAFE PROCEDURE REGARDING SEVERE BLEEDING IN PRESENCE OF CORONA MORTIS: A STUDY IN 13 WOMEN.
Cicconetti1; Pietro Saldutto1; Daniele Castellani1; Vikiela Galica1; Daniela Biferi1; Giovanni Giovanditti1; Giuseppe Paradiso Galatioto1;
1 Department of Health Science, University of L'Aquila, Teramo Hospital, Italy
Topic: Stress urinary incontinence.
and life-threatening bleeding has been reported in the literature after retropubic mid-urethral slings procedure, due to corona mortis (CMOR) damage.
The aim of this study is to evaluated safety of transobturator passage of the tape in stress-urinary incontinence (SUI) correction and anchoring the mesh
in pelvic.-organ prolapse (POP) repair in the presence of CMOR
Materials and Methods. Thirteen woman with a pre-operatory contrast-enhanced abdominal multidetector computed tomography were prospectively enrolled
in the study between January 2009 and December 2014. Eight woman underwent a Monarc® and one a Spark® Sling System procedures for SUI correction, and
three an Elevate® Anterior and Apical prolapse system and one a Perigee procedure to repair anterior/apical POP. All procedures were performed by single
experienced pelvic surgeon (C.V.).
was uneventful in all cases. No mayor bleeding was seen during surgery. No pelvic hematoma was identified 24-hours after the procedure. All woman were
discharged one-day after surgery.
study confirms that transoburator surgery is a safe procedure to correct SUI and repair POP regarding serious and life-threatening bleeding, even in presence
- Hunskaar S, Burgio K, Clark A, et al. (2005) Epidemiology of urinary and faecal incontinence and pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury
S, Wein A, editors. Incontinence, 3rd International Consultation on Incontinence. Plymouth, United Kingdom: Health Publications; pp. 255–312.
C, Feiner B, Baessler K, Schmid C (2013) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 30;4:CD004014
R, Urquhart DM, Davis SR, Bell RJ. (2008) Prevalence and incidence of urinary incontinence in women: review of the literature and investigation
of methodological issues. Int J Urol 15:230–4.
- Ulmsten U, Henriksson L, Johnson P, Varhos G. (1996) An ambulatory surgical procedure under local
anesthesia for treatment of female urinary incontinence. Int Urogynecol J 7:81–6.
- Hu TW, Wagner TH, Bentkover JD, et al. (2004) Costs of urinary
incontinence and overactive bladder in the United States: a comparative study. Urology 63:461–5.
- Subak LL, Waetjen LE, van den Eeden S, et al.
(2001) Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol 98:646-651.
- Serious complications associated with transvaginal
placement of surgical mesh in repair of pelvic organ prolapse and stress urinary incontinence. October 20, 2008. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm
- Novara G, Galfano A, Boscolo-Berto R, Secco S et al. (2008) Complication Rates of Tension-Free Midurethral Slings in the Treatment of Female Stress
Urinary Incontinence: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Comparing Tension-Free Midurethral Tapes to Other Surgical
Procedures and Different Devices. Eur Urol 53: 288-309.