Treatment of Urge Urinary Incontinence in Women After Failure of Cesa or Vasa

Phase 1/2 Study of the Effect of TOT or Solifenacin After Cesa or Vasa on Urge Urinary Incontinence

Urge urinary incontinence can be a disorder caused by destroyed pelvic structures. We repaired the uteri-sacral ligaments (USL) by cesa or vasa. The study evaluates if solifenacin can lead to continence after surgery or if also the pubo-urethral ligaments (PUL) need to be repaired.

It was hypothesized that urge urinary incontinence in women is based on the destruction of the uteri-sacral ligaments (USL)and the pubourethral ligaments (PUL). In a preliminary study (URGE I) we repaired the USL by cesa or vasa. Those patients who are still incontinent after cesa and vasa get the repair of the PUL by means of trans-obturator tapes (TOT). That treatment is compared to conservative medical treatment. Cross over after completion of three months is possible if no continence is achieved.

Inclusion Criteria:

• prior vasa or cesa operation as part of the URGE I study
• stress urinary incontinence
• mixed urinary incontinence

Exclusion Criteria:

• previous urogynecological surgery
• avulsion of cesa or vasa tape
• pregnancy
• neurologic/psychological reasons for incontinence
• body weight >100kg
• syndrome of dry overactive bladder