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Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome.
Aust N Z J Obstet Gynaecol. 2015 Dec; 55(6):593-600.AN

Abstract

INTRODUCTION

To clinically and sonographically evaluate the influence of anterior vaginal mesh (AVM) surgery with concomitant mid-urethral sling surgery (MUS) for stress urinary incontinence (SUI).

MATERIALS AND METHODS

Women with severe symptomatic pelvic organ prolapse (POP) stage III or IV with concomitant SUI were divided into two groups: Group I had transobturator tape (TOT) and AVM surgery and Group II underwent TOT without AVM surgery. Clinical outcome was assessed pre-operatively and 1 year post-operatively, while ultrasound evaluations were performed after one year. Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry. Subjective SUI cure was a negative response to Urogenital Distress Inventory Six (UDI-6) (question 3).

RESULTS

A total of 97 women were recruited, 57 in Group I and 40 in Group II. Three women had symptomatic prolapse in Group I and 5 in Group II. There were no differences in the ultrasound and clinical outcomes between women who had mid-urethral slings with and without AVM. Successful SUI outcome was reported in 85 women. Urethral kinking was demonstrable in 50% of successful cases, but none with failed outcomes. Subanalysis among those with successful SUI outcome (n = 85) and failure (n = 12) revealed the tape, bladder neck and mesh mobility was significantly higher (P < 0.001) among those with SUI success.

CONCLUSIONS

Among women who had MUS, there were no differences in the ultrasound and clinical outcome between those who had AVM or otherwise.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Keelung and Taipei, Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan. Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou, Taiwan. School of Medicine, Chang Gung University, Taoyuan, Taiwan.Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Department of Obstetrics & Gynecology, Kuching Specialist Hospital, KPJ, Sarawak, Malaysia.Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Department of Obstetrics & Gynecology, De La Salle University Medical Center, Dasmariñas, Cavite, Philippines.Linkou Medical Center, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.Department of Obstetrics and Gynecology, Keelung and Taipei, Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan. Linkou Medical Center, Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Department of Obstetrics & Gynecology, Hospital Serdang, Kajang, Selangor, Malaysia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26299981

Citation

Lo, Tsia-Shu, et al. "Influence of Anterior Vaginal Mesh With Concomitant Mid-urethral Sling Surgery On Stress Urinary Incontinence: Clinical and Sonographic Outcome." The Australian & New Zealand Journal of Obstetrics & Gynaecology, vol. 55, no. 6, 2015, pp. 593-600.
Lo TS, Tan YL, Cortes EF, et al. Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome. Aust N Z J Obstet Gynaecol. 2015;55(6):593-600.
Lo, T. S., Tan, Y. L., Cortes, E. F., Lin, Y. H., Wu, P. Y., & Pue, L. B. (2015). Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 55(6), 593-600. https://doi.org/10.1111/ajo.12397
Lo TS, et al. Influence of Anterior Vaginal Mesh With Concomitant Mid-urethral Sling Surgery On Stress Urinary Incontinence: Clinical and Sonographic Outcome. Aust N Z J Obstet Gynaecol. 2015;55(6):593-600. PubMed PMID: 26299981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome. AU - Lo,Tsia-Shu, AU - Tan,Yiap Loong, AU - Cortes,Eileen Feliz Mendoza, AU - Lin,Yi-Hao, AU - Wu,Pei-Ying, AU - Pue,Leng Boi, Y1 - 2015/08/24/ PY - 2015/02/27/received PY - 2015/07/14/accepted PY - 2015/8/25/entrez PY - 2015/8/25/pubmed PY - 2016/10/13/medline KW - mid-urethral sling KW - pelvic organ prolapse KW - stress incontinence KW - transvaginal mesh KW - ultrasound SP - 593 EP - 600 JF - The Australian & New Zealand journal of obstetrics & gynaecology JO - Aust N Z J Obstet Gynaecol VL - 55 IS - 6 N2 - INTRODUCTION: To clinically and sonographically evaluate the influence of anterior vaginal mesh (AVM) surgery with concomitant mid-urethral sling surgery (MUS) for stress urinary incontinence (SUI). MATERIALS AND METHODS: Women with severe symptomatic pelvic organ prolapse (POP) stage III or IV with concomitant SUI were divided into two groups: Group I had transobturator tape (TOT) and AVM surgery and Group II underwent TOT without AVM surgery. Clinical outcome was assessed pre-operatively and 1 year post-operatively, while ultrasound evaluations were performed after one year. Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry. Subjective SUI cure was a negative response to Urogenital Distress Inventory Six (UDI-6) (question 3). RESULTS: A total of 97 women were recruited, 57 in Group I and 40 in Group II. Three women had symptomatic prolapse in Group I and 5 in Group II. There were no differences in the ultrasound and clinical outcomes between women who had mid-urethral slings with and without AVM. Successful SUI outcome was reported in 85 women. Urethral kinking was demonstrable in 50% of successful cases, but none with failed outcomes. Subanalysis among those with successful SUI outcome (n = 85) and failure (n = 12) revealed the tape, bladder neck and mesh mobility was significantly higher (P < 0.001) among those with SUI success. CONCLUSIONS: Among women who had MUS, there were no differences in the ultrasound and clinical outcome between those who had AVM or otherwise. SN - 1479-828X UR - https://www.unboundmedicine.com/medline/citation/26299981/Influence_of_anterior_vaginal_mesh_with_concomitant_mid_urethral_sling_surgery_on_stress_urinary_incontinence:_clinical_and_sonographic_outcome_ L2 - https://doi.org/10.1111/ajo.12397 DB - PRIME DP - Unbound Medicine ER -