Predictors for de novo stress urinary incontinence following pelvic reconstruction surgery with transvaginal single-incisional mesh

Pei-Chi Wu,Cheng-Yu Long,Yiyin Liu,Chin-Hu Wu,Zixi Loo,Kun-Ling Lin,Yung-Chin Lee

doi:10.1038/s41598-019-55512-0

Abstract

The study aims to identify predictors for de novo stress urinary incontinence (SUI) following Elevate mesh surgery. A total of 164 women who underwent Elevate mesh surgeries between November 2011 and February 2014 in a single center were included. Seventy-three women were excluded due to preoperative incontinence or concomitant mid-urethral sling surgery. Fourteen others were excluded due to incomplete medical records. Fisher’s exact test and χ2 test were applied. The univariate logistic regression was used for odds ratios. Of the 77 continent women, 24 (31.2%) experienced de novo SUI after the operation. Significantly more women with de novo SUI were over the age of 64 years (75.0% vs. 47.2%, p = 0.023, OR 3.36, 95% CI 1.15–9.79). Preoperative occult urodynamic stress incontinence (29.2% vs. 3.8%, p = 0.003, OR 10.0, 95% CI 2.0–50.0) and previous SUI history (41.7% vs. 7.6%, p = 0.001, OR 9.1, 95% CI 2.38–33.3) were 2 other predictors of de novo SUI postoperatively. In conclusion, age over 64 years old, occult urodynamic stress incontinence, and previous history of SUI are 3 significant predictors for de novo SUI following the single-incision mesh surgeries.

Highlights

The study aims to identify predictors for de novo stress urinary incontinence (SUI) following Elevate mesh surgery
Studies revealed evidence that prolapse surgery combined with anti-incontinence surgery reduces the risk of postoperative SUI5,6; whereas, others warn the risk of difficulty voiding, urinary urgency or urge incontinence, urinary tract injuries and more medical costs in combined surgery[3,7,8,9]
Elevate mesh is the generation of the Perigee system, using type I polypropylene Intepro Lite mesh and single vaginal incision procedure that reaches obturator fascia and sacrospinous ligament. His colleagues conducted a study mainly focusing on the predictors of de novo SUI after POP surgeries, including trans-obturator 4-arm mesh and native tissue[12]

Summary

Introduction

The study aims to identify predictors for de novo stress urinary incontinence (SUI) following Elevate mesh surgery. Preoperative occult urodynamic stress incontinence (29.2% vs 3.8%, p = 0.003, OR 10.0, 95% CI 2.0–50.0) and previous SUI history (41.7% vs 7.6%, p = 0.001, OR 9.1, 95% CI 2.38–33.3) were 2 other predictors of de novo SUI postoperatively. Age over 64 years old, occult urodynamic stress incontinence, and previous history of SUI are 3 significant predictors for de novo SUI following the single-incision mesh surgeries. Elevate mesh is the generation of the Perigee system, using type I polypropylene Intepro Lite mesh and single vaginal incision procedure that reaches obturator fascia and sacrospinous ligament Lo, and his colleagues conducted a study mainly focusing on the predictors of de novo SUI after POP surgeries, including trans-obturator 4-arm mesh and native tissue[12]. We attempt to identify the predictive factors for de novo SUI following Elevate mesh placement

Methods

Results

Conclusion