Does anchoring vaginal mesh increase the potential for correcting stress incontinence?

Abstract

BackgroundThis study aims to explore the feasibility of anchoring a four-arm transvaginal mesh (TVM) to the mid-urethra to correct an anterior compartment POP–Quantification stage II–III (Q II–III) and concomitant genuine SUI.MethodsWe analysed clinical data from 248 patients with stage II–III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2008 and June 2010. One hundred and twenty-four women treated with anterior colporrhaphy and 62 patients implanted with a conventional permanent TVM were selected as historical matched controls. Sixty-two patients received a modified permanent TVM, where the mesh was fixed to the mid-urethra with two stitches for the purpose of potentially correcting SUI. Surgical complications were classified using the Clavien–Dindo (CD) classification system.ResultsThe anti-SUI efficacy was minimally higher in the mTVM group than in the original TVM group (p = 0.44, 96.8% vs 91.9%, respectively), while prosthesis surgery was more effective than anterior colporrhaphy in improving the anterior compartment POP–Q status (96.8, 90.3% vs 64.5%, respectively). Anchoring the mesh did not increase the extrusion rate (p = 0.11). The de novo urge symptoms were not more prevalent among those who had received additional periurethral stitches (p = 1.00, 11.3% vs 12.9%). The incidence of reoperation observed in the mTVM group was non-significantly lower than that in the TVM group (p = 0.15, 6.5% vs 16.1%); however, the difference did not reach the level of significance. The early postoperative complication profile was more favourable among the mTVM patients (classified as CD I: 8.1%; CD II: 1.6%; and CD IIIb: 1.6%) as compared to the TVM group (p = 0.013).ConclusionsThe new, modified mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications.

Nghiên Cứu Đặc Điểm Lâm Sàng Và Đánh Giá Kết Quả Phẫu Thuật Điều Trị Sa Bàng Quang Ở Phụ Nữ Bằng Phẫu Thuật Đặt Giá Đỡ Nâng Bàng Quang Qua Lỗ Bịt Tại Bệnh Viện Trường Đại Học Y Dược Cần Thơ Và Bệnh Viện Đa Khoa Trung Ương Cần Thơ

“…Tuổi trung bình của các đối tượng nghiên cứu là 65,5 tuổi, số liệu của chúng tôi tương đương báo cáo của N.V.Ân là 64 tuổi [1], Stephen B. Young là 62 tuổi [12] Fekete (2018) là 62 tuổi [8]. Sa bàng quang tăng theo độ tuổi của phụ nữ và theo y văn đã ghi nhận sa bàng quang thường gặp ở những phụ nữ lớn tuổi và nguy cơ mắc bệnh tăng theo tuổi.…”