Abstract
This retrospective cohort study aims to assess the clinical and urodynamic outcomes of single-incision mesh surgery with the Uphold system. The medical records of 140 women with anterior and/or apical compartment prolapse stage 2 or greater who underwent Uphold mesh surgeries were reviewed. The clinical evaluation included a pelvic examination, a urodynamic study (UDS), and a personal interview to evaluate lower urinary tract symptoms (LUTS). After a follow-up time of 12–30 months, the anatomical reduction rates were 100% and 96.4% for the apical and anterior compartments, respectively, and these rates were similar across women with or without hysterectomy. All of the LUTS and several UDS parameters improved significantly. The continence rate in women with stress urinary incontinence (SUI) was improved if they also underwent a mid-urethral sling (MUS) operation. However, the continence rate did not differ between women with and without occult urodynamic stress incontinence who did not undergo a concomitant MUS operation. The rate of vaginal mesh extrusion was 2.8%, and this complication rarely occurred beyond the learning curve. In conclusion, the anatomic correction of the Uphold system was satisfactory with a low rate of mesh extrusion. Women with SUI would benefit from a concomitant MUS operation.
Highlights
This retrospective cohort study aims to assess the clinical and urodynamic outcomes of single-incision mesh surgery with the Uphold system
For women with dominant apical prolapse, single-incision mesh surgery using the Uphold transvaginal mesh (TVM) system resulted in an ideal anatomical reduction and an improvement in lower urinary tract symptoms (LUTS), with an acceptable vaginal mesh extrusion rate
The review of the chart records consisted of a detailed history before and after the surgery until the patient’s last follow-up, including urinary analysis, pelvic examination, urodynamic study (UDS), transabdominal ultrasound, and personal interview to identify any urinary symptom taking into account the 2002 International Continence Society (ICS) definitions[37]
Summary
This retrospective cohort study aims to assess the clinical and urodynamic outcomes of single-incision mesh surgery with the Uphold system. The medical records of 140 women with anterior and/or apical compartment prolapse stage 2 or greater who underwent Uphold mesh surgeries were reviewed. The continence rate in women with stress urinary incontinence (SUI) was improved if they underwent a mid-urethral sling (MUS) operation. Numerous procedures regarding level 1 support have been described, fixation with grafts is still one of the options in the flowchart[9] It appears that TVM still plays a role in Scientific Reports | (2020) 10:13506. Parameters Age (years) Parity BMI (kg/m2) Menopause Current smoker Diabetes mellitus Hypertension History of hysterectomy Concomitant procedures in this study Posterior repair with mesh Posterior colporrhaphy Vaginal hysterectomy Mid-urethral sling Follow-up (months). The design of the Uphold system is based on bilateral sacrospinous fixation with the aid of a Capio suture capturing device for the apical compartment and a lightweight mesh body covering the anterior compartment
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