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KK Urogynaecology Centre

KK Urogynaecology Centre - The 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.

Currently, it has one full-time urogynaecologists, three visiting urogynaecologists, six supporting doctors and three urodynamic-trained nurses. The KK UG Centre is equipped with sophisticated equipment to help accurately diagnose urogynaecological problems. Its aim is to provide the best, cost effective and affordable medical care to patients.

The Centre saw 2,614 new patients, 12,281 follow-up patients and did 1,237 urodynamic studies in 2012.

The Centre also conducts training for both local and overseas doctors, medical students 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:

  • Manchester Operation
  • Mesh (Elevate) augmented pelvic floor repair
  • Pelvic Floor Repair
  • Sacrocolpopexy
  • Sacrohysteropexy
  • Sacrospinous Hysteropexy
  • Sacrospinous Ligament Fixation (SSF)
  • Vaginal Hysterectomy (VH)

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, meshes such as Prolift or Elevate have been used to reinforce the cystourethrocoele repair in severe or recurrent bladder prolapse.

We are among the first few centres in Asia to start using Gynemesh*PS, the Prolift Mesh® system and the Elevate in pelvic floor reconstructive surgeries for severe or recurrent bladder, vault or uterine prolapse.

Pelvic Organ ProlapseOne Year Cure Rate*
Vaginal Hysterectomy95%
Manchester Operation100%
Cystourethrocoele Repair83%
Rectocoele Repair96%
Sacrospinous Ligament Fixation (SSF) for vault or severe uterine prolapse95%
Gynemesh*PS in Cystourethrocoele Repair86%
Anterior Prolift for severe or recurrent Cystourethrocoele95%
Posterior Prolift for severe Retocoele/Vault Prolapse100%
Total Prolift for severe Pelvic Organ Prolapse or severe Cystourethrocoele with Vault Prolapse88%
Anterior Elevate for severe or recurrent Cystourethrocoele96%
Sacrocolpopexy95%
Sacrohysteropexy95%

* 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 SUI are:

  • Burch Colposuspension
  • Tension-free Vaginal Tape (TVT)
  • Tension-free Vaginal Tape-Obturator (TVT-O)
  • Tension-free Vaginal Tape-Exact (TVT-Exact)
  • Tension-free Vaginal Tape-Abbrevo (TVT-Abbrevo)

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 for treating female stress urinary incontinence. 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, we have performed more than 1,500 TVT-O procedures.

In September 2011 and early 2012, we have started using the new modified versions (TVT-Abbrevo and TVT-Exact respectively) to treat SUI which are supposed to be equally effective and with fewer complications.

ProcedureCured (%)Improved (%)Failure (%)
TVT   
1-Year91.28.40.3
5-Year73.018.28.8
TVT-Exact
6 months81.816.71.5
1-Year86.713.30
TVT-0   
1-Year92.87.20
5-Year64.427.97.7
TVT-Abbrevo   
6 months89.18.72.2
1-Year94.45.60

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