Stress urinary incontinence after transvaginal mesh surgery for anterior and apical prolapse: preoperative risk factors View Full Text


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Article Info

DATE

2020-06-12

AUTHORS

Mathilde Bideau, Lucie Allègre, Geertje Callewaert, Brigitte Fatton, Renaud de Tayrac

ABSTRACT

Introduction and hypothesisDebate persists over whether surgery to correct pelvic organ prolapse (POP) should be combined with midurethral sling (MUS) insertion. The aim of this study was to evaluate the incidence of stress urinary incontinence (SUI) up to 12 months after transvaginal mesh surgery, with or without MUS, and to identify risk factors for postoperative SUI.MethodsThis retrospective single-center study included patients who underwent transvaginal mesh surgery with Uphold™ between October 2010 and December 2017. The primary outcome was the prevalence of SUI at 12 months postoperatively. Univariate and multivariate logistic regression was used to identify risks factors for postoperative SUI.ResultsOf the 308 women included, 123 (40%) were continent (no SUI), 108 (35%) had SUI, and 76 (25%) had occult SUI. Forty-nine patients (15.9%) had a concomitant MUS procedure. At 12 months after surgery, 35.9% of patients without concomitant MUS had SUI vs 14.3% with (p = 0.003). Thirty-five patients (29%) developed de novo SUI. Postoperative complications were more common in patients with concomitant MUS (30.6% vs 17%; p = 0.003). The best predictor of postoperative SUI was the presence of preoperative SUI (OR 2.52 (1.25–5.09). Concomitant MUS (p < 0.001), and prior POP surgery (p = 0.034) were protective factors for postoperative SUI.ConclusionPreoperative SUI is the most important risk factor for postoperative SUI. However, given the higher risk of postoperative complications with concomitant MUS and the acceptable rate of de novo SUI rate without it, two-stage surgery seems preferable for patients with preoperative SUI. More... »

PAGES

111-117

References to SciGraph publications

  • 2016-01-06. Vaginal prolapse repair with or without a midurethral sling in women with genital prolapse and occult stress urinary incontinence: a randomized trial in INTERNATIONAL UROGYNECOLOGY JOURNAL
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  • 2010-03-30. Occult incontinence in women with pelvic organ prolapse - does it matter? in EUROPEAN JOURNAL OF MEDICAL RESEARCH
  • 2015-04-11. Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2018-07-14. Anterior-apical single-incision mesh surgery (uphold): 1-year outcomes on lower urinary tract symptoms, anatomy and ultrasonography in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2016-02-13. Pelvic organ prolapse repair using the Uphold™ Vaginal Support System: a 1-year multicenter study in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2016-09-27. De novo stress urinary incontinence after pelvic organ prolapse surgery in women without occult incontinence in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2009-11-26. Surgical strategies for women with pelvic organ prolapse and urinary stress incontinence in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2009-05-15. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-10-19. Pelvic organ prolapse surgery and bladder function in INTERNATIONAL UROGYNECOLOGY JOURNAL
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    http://scigraph.springernature.com/pub.10.1007/s00192-020-04363-9

    DOI

    http://dx.doi.org/10.1007/s00192-020-04363-9

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1128455673

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32533213


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