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"Mesh free" autologous transobturator mid urethral sling placement for predominant stress urinary incontinence: A pilot study.
Neurourol Urodyn. 2021 02; 40(2):659-665.NU

Abstract

AIMS

To assess the efficacy and safety of autologous mid-urethral sling (MUS) in women with predominant stress urinary incontinence (SUI).

MATERIALS AND METHODS

This prospective cohort study included adult women with predominant SUI seen in our urology clinic between January 2018 and March 2019. Patients with: negative cough stress test, history of prior incontinence surgery, urogenital malignancy, pelvic radiation, neurological disease, body mass index more than 40 kg/m2 , the presence of more than Stage I pelvic organ prolapse, active urinary tract infection, maximum flow rate less than 15 ml/sec, postvoid residual urine more than 100 ml, abdominal leak point pressure less than 60 cm of H2 O, and pregnant women were excluded. Eligible patients underwent a transobturator MUS procedure using rectus fascia as a sling. Before the procedure, patients filled the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptom (ICIQ-FLUTS) and the Female Sexual Function Index (FSFI) questionnaire. Urinary outcomes were assessed at 3- and 12-months while sexual outcomes were assessed at 12-months.

RESULTS

Thirty patients with median age of 44.5 years were included. All patients had a negative cough stress test during follow up. A significant improvement was noted in the ICIQ-FLUTS scale, bother scale, filling and incontinence subscales at 3 and 12 month follow-up. A significant improvement was also noted in the FSFI full scale score and FSFI domains of mean sexual desire, arousal and lubrication at 12 months follow-up. Two patients developed voiding dysfunction requiring urethral dilatation.

CONCLUSION

Autologous transobturator MUS surgery appears to be safe and efficacious in the short term. More research is needed to clarify its role in the surgical management of SUI in women.

Authors+Show Affiliations

Department of Urology and Renal transplant, VM Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal transplant, VM Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal transplant, VM Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal transplant, VM Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal transplant, VM Medical College and Safdarjang Hospital, New Delhi, India.Department of Urology and Renal transplant, VM Medical College and Safdarjang Hospital, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33348447

Citation

Vasudeva, Pawan, et al. ""Mesh Free" Autologous Transobturator Mid Urethral Sling Placement for Predominant Stress Urinary Incontinence: a Pilot Study." Neurourology and Urodynamics, vol. 40, no. 2, 2021, pp. 659-665.
Vasudeva P, Tyagi V, Kumar N, et al. "Mesh free" autologous transobturator mid urethral sling placement for predominant stress urinary incontinence: A pilot study. Neurourol Urodyn. 2021;40(2):659-665.
Vasudeva, P., Tyagi, V., Kumar, N., Yadav, S., Prasad, V., & Iyer, S. G. (2021). "Mesh free" autologous transobturator mid urethral sling placement for predominant stress urinary incontinence: A pilot study. Neurourology and Urodynamics, 40(2), 659-665. https://doi.org/10.1002/nau.24599
Vasudeva P, et al. "Mesh Free" Autologous Transobturator Mid Urethral Sling Placement for Predominant Stress Urinary Incontinence: a Pilot Study. Neurourol Urodyn. 2021;40(2):659-665. PubMed PMID: 33348447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "Mesh free" autologous transobturator mid urethral sling placement for predominant stress urinary incontinence: A pilot study. AU - Vasudeva,Pawan, AU - Tyagi,Vijay, AU - Kumar,Niraj, AU - Yadav,Siddharth, AU - Prasad,Vishnu, AU - Iyer,Saumya G, Y1 - 2020/12/21/ PY - 2020/10/23/received PY - 2020/12/02/revised PY - 2020/12/08/accepted PY - 2020/12/22/pubmed PY - 2021/6/23/medline PY - 2020/12/21/entrez KW - ICIQ-FLUTS KW - ICS-UCST KW - autologous sling KW - mid-urethral sling KW - stress urinary incontinence SP - 659 EP - 665 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 40 IS - 2 N2 - AIMS: To assess the efficacy and safety of autologous mid-urethral sling (MUS) in women with predominant stress urinary incontinence (SUI). MATERIALS AND METHODS: This prospective cohort study included adult women with predominant SUI seen in our urology clinic between January 2018 and March 2019. Patients with: negative cough stress test, history of prior incontinence surgery, urogenital malignancy, pelvic radiation, neurological disease, body mass index more than 40 kg/m2 , the presence of more than Stage I pelvic organ prolapse, active urinary tract infection, maximum flow rate less than 15 ml/sec, postvoid residual urine more than 100 ml, abdominal leak point pressure less than 60 cm of H2 O, and pregnant women were excluded. Eligible patients underwent a transobturator MUS procedure using rectus fascia as a sling. Before the procedure, patients filled the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptom (ICIQ-FLUTS) and the Female Sexual Function Index (FSFI) questionnaire. Urinary outcomes were assessed at 3- and 12-months while sexual outcomes were assessed at 12-months. RESULTS: Thirty patients with median age of 44.5 years were included. All patients had a negative cough stress test during follow up. A significant improvement was noted in the ICIQ-FLUTS scale, bother scale, filling and incontinence subscales at 3 and 12 month follow-up. A significant improvement was also noted in the FSFI full scale score and FSFI domains of mean sexual desire, arousal and lubrication at 12 months follow-up. Two patients developed voiding dysfunction requiring urethral dilatation. CONCLUSION: Autologous transobturator MUS surgery appears to be safe and efficacious in the short term. More research is needed to clarify its role in the surgical management of SUI in women. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/33348447/"Mesh_free"_autologous_transobturator_mid_urethral_sling_placement_for_predominant_stress_urinary_incontinence:_A_pilot_study_ DB - PRIME DP - Unbound Medicine ER -