Predictors of an improvement in the severity of concomitant urodynamic stress incontinence after transvaginal mesh surgery for pelvic organ prolapse
Sheng-Mou Hsiao, Ting-Chen Chang, Pei-Chi Wu, Ho-Hsiung Lin, Sheng-Mou Hsiao, Ting-Chen Chang, Pei-Chi Wu, Ho-Hsiung Lin
Abstract
Background/purpose: Factors affecting the anti-incontinence efficacy of a tailored anterior transvaginal mesh (ATVM) surgery are undetermined. Thus, our aim was to investigate predictors for anti-incontinence efficacy of this ATVM surgery.
Methods: Medical records of women with pelvic organ prolapse and concomitant evident or occult urodynamic stress incontinence, who underwent the ATVM surgery but without concomitant anti-incontinence surgery, were reviewed.
Results: A total of 134 women were reviewed, including those who underwent ATVM only (n = 45), ATVM and posterior transvaginal mesh surgery (n = 88), and ATVM with total vaginal hysterectomy (n = 1). Multivariable analysis revealed that stage of cystocele (coefficient = 56.4), functional profile length (cm, coefficient = 61.1) and the score of general health perceptions in the King's Health Questionnaire (coefficient = -3.3) were independent predictors of the percentage change in pad weight from baseline. Seven (5.2%) women were found to have recurrent or persistent stress urinary incontinence, and 6 of the above 7 women underwent transobturator mid-urethral sling procedure. Free of further anti-incontinence surgery probabilities were 94.7% and 89.2% at 3 and 6 years after surgery, respectively. Functional profile length (hazard ratio = 2.61) was also identified as a predictor for further anti-incontinence surgery.
Conclusion: Lesser degree of cystocele, shorter functional profile length and poorer general health perceptions were predictors of greater anti-incontinence effect after the tailored ATVM surgery. Besides, longer functional profile length was also a predictor for further anti-incontinence surgery after the ATVM surgery.
Keywords: Pelvic organ prolapse; Stress urinary incontinence; Surgical mesh.
Conflict of interest statement
Declaration of Competing Interest The authors have no conflicts of interest relevant to this article.
Copyright © 2020. Published by Elsevier B.V.
Source: PubMed