KK Urogynaecology (UG) Centre is the first urogynaecology centre in Asia to provide one-stop services for the investigation and treatment of female bladder disorders and pelvic floor dysfunction.The KK UG Centre is equipped with sophisticated equipment to help accurately diagnose urogynaecological problems. Its aim is to provide the best and affordable medical care to patients.
The Centre saw 2,046 new patients and 6,789 follow-up patients in 2006. Currently, it has 3 full-time urogynaecologists, 2 visiting urogynaecologists and 2 urodynamic-trained nurses.
The Centre also conducts training for both local and overseas doctors and is intensively involved in clinical research.
• Clinical Outcome of Pelvic Organ Prolapse
Pelvic organ prolapse (POP) is a common condition & 10% of the female population has symptomatic POP.
The surgeries offered by the centre for the treatment of POP are:
• Vaginal Hysterectomy (VH)
• Manchester Operation
• Pelvic Floor Repair
• Sacrocolpopexy
• Sacrospinous Ligament Fixation (SSLF)
• Sacrohysteropexy
• Gynaemesh in Cystourethrocele repair
• Sacrospinous Hysteropexy
• Prolift Mesh system for severe POP
We perform an average of 400 vaginal hysterectomies, 500 pelvic floor repairs and 100 sacrospinous ligament fixations each year for the treatment of pelvic organ prolapse.
Vaginal hysterectomy has an excellent surgical outcome with low post-operative morbidity and can be performed concurrently with other prolapse or continence surgeries.
Depending on the type and severity of vaginal wall prolapse, the pelvic floor repair can be either for the correction of bladder prolapse (cystourethrocele) or rectal prolapse (rectocele). In the past few years, Gynemesh *PS has been used to reinforce the cystourethrocele repair in severe bladder prolapse. This has been superseded recently by the use of the Prolift Mesh system, where the patient can decide to remove or to conserve the womb.
We are the first centre in Asia to start using Gynemesh*PS & the Prolift mesh system in pelvic floor reconstructive surgeries for severe bladder, vault or uterine prolapse.
Pelvic Organ Prolapse One Year Cure Rate*
Pelvic Floor Repair (PFR)
- Cystourethrocele Repair
- Rectocele Repair
83%
96%
Sacrospinous Ligament Fixation (SSLF)
- Severe Uterine Prolapse
- Vault Prolapse
96%
94%
Gynemesh*PS in Cystourethrocele Repair
86%
Anterior Prolift for severe or recurrent Cystourethrocoele
Posterior Prolift for severe Retocoele or Vault Prolapse
Total Prolift for severe Pelvic Organ Prolapse or severe Cystourethrocele
with Vault Prolapse
95%
100%
88%
* The cure rate is defined as the percentage of patients who has undergone the operation successfully without any recurrence.
• Clinical Outcome of Stress Urinary Incontinence (SUI)
Stress Urinary Incontinence affects 12-15% of the women population. For women who are 50 years old and above, the risk of having SUI increases to 1 in 3 women.
The common surgeries for the treatment of SUI are:
• Burch Colposuspension
• Tension-free Vaginal Tape (TVT)
• Tension-free Vaginal Tape-Obturator (TVT-O)
The Burch Colposuspension was formerly the gold standard in the surgical treatment of female SUI. With the invention of TVT in 1996, TVT has revoluntionalised the surgical treatment of female SUI and is now the gold standard. KK UG Centre is proud to be the second centre in Asia to introduce the TVT procedure in late 1998. We have performed more than 1,800 TVT procedures to date.
With the constant advancement in surgical techniques and devices, the operative time and complication rates have been further reduced with the introduction of the TVT-O. In 2004, KK UG Centre was the first in Asia to perform the TVT-O procedure, and since then, it has performed more than 800 TVT-O procedures.
Stress Urinary Incontinence
One Year Outcome*
Cure
Improved
Failure
Burch Colposuspension 90% 10% 0% TVT 94% 4.8% 1.2% TVT-O 95.2%
3.6% 1.2%
* The definition of Cure, Improved & Failure are as follows:
Cure: Symptoms successfully treated and tests were negative
Improvement: Symptoms improved significantly
Failure: Persistent of symptoms
In August 2006, the KK UG Centre has started performing TVT-SECUR procedure which can further reduce the risk & morbidity of surgery. The Centre is once again the first in Asia to start this procedure. The long-term results of TVT-SECUR are still under evaluation.
