KK Urogynaecology Centre
KK Urogynaecology Centre Centre for Advanced Pelvic Floor Reconstruction and Bladder Dysfunction.
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 2,257 new patients, 7,704 follow-up patients and did 1,822 urodynamic studies in 2007. Currently, it has three full-time urogynaecologists, two visiting urogynaecologists and three urodynamic-trained nurses.
The Centre also conducts training for both local and overseas doctors and nurses and is intensively involved in clinical research.
Outcome of Pelvic Organ Prolapse
Pelvic organ prolapse (POP) is a common condition with approximately 10% of the female population having symptomatic POP.
The surgeries offered by the centre for the treatment of POP are:
- Vaginal Hysterectomy (VH)
- Pelvic Floor Repair
- Sacrocolpopexy
- Vaginaplasty
- Prolift Mesh® system for severe POP
- Sacrohysteropexy
- Sacrospinous Hysteropexy
- Sacrospinous Ligament Fixation (SSLF)
- Manchester Operation
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.
The pelvic floor repair is for the correction of bladder prolapse (cystourethrocoele) or rectal prolapse (rectocoele). In the past few years, Gynemesh *PS has been used to reinforce the cystourethrocoele repair in severe bladder prolapse. This has been superseded recently by the use of the Prolift Mesh® system.
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) |
|
| Cystourethrocoele Repair |
83% |
| Rectocoele Repair |
96% |
| Sacrospinous Ligament Fixation (SSLF) |
|
| Severe Uterine Prolapse |
96% |
| Vault Prolapse |
94% |
| Gynemesh*PS in Cystourethrocoele Repair |
86% |
| Anterior Prolift for severe or recurrent Cystourethrocoele |
95% |
| Posterior Prolift for severe Retocoele Vault Prolapse |
100% |
| Total Prolift for severe Pelvic Organ Prolapse or severe Cystourethrocoele with Vault Prolapse |
88% |
* The cure rate is defined as the percentage of patients who has undergone the operation successfully with no or grade 1 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 one in three women.
The surgeries offered by the centre for the treatment of POP 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 revolutionised 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 2,000 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 1,000 TVT-O procedures.
| Procedure |
Cured (%) |
Improved (%) |
Failure (%) |
| TVT |
|
|
|
| I-Year |
93.3 |
6.7 |
0 |
| 2-Year |
93.7 |
6.3 |
0 |
| 3-Year |
92.4 |
7.6 |
0 |
| TVT-0 |
|
|
|
| I-Year |
93.3 |
6.7 |
0 |
| 1.5-Year |
93.7 |
6.3 |
0 |
| Burch Colposuspension |
|
|
|
| I-Year |
93.3 |
6.7 |
0 |
The definition of Cure, Improved & Failure are as follows:
Cure:
- Symptoms successfully treated and tests were negative
- Improvement: Symptoms improved significantly
- Failure: Persistence of symptoms
Treatment Options & Clinical Outcomes for Stress Urinary Incontinence (SUI)
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.