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  • Title: Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome.
    Author: Lo TS, Tan YL, Cortes EF, Lin YH, Wu PY, Pue LB.
    Journal: Aust N Z J Obstet Gynaecol; 2015 Dec; 55(6):593-600. PubMed ID: 26299981.
    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.
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