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Introduction: Patients without concurrent baseline stress urinary incontinence (SUI) can develop de novo SUI after transvaginal mesh surgery (TVM) for cystocele repair. Surgeons should be aware of de novo SUI risk factors after TVM.

Methods: A total of 1124 women who were underwent TVM surgeries were recruited and assessed for eligibility from January 1, 2012 to April 30, 2021. All data related to patients and surgeries was collected, which included general conditions, clinical examination, surgery records, and follow-up results. Patients were divided into three groups according to follow-up results and data were compared with each group. The relative risk (RR) of de novo SUI with levator avulsion was also calculated.

Results: Three hundred thirty-six patients were included in this study. They were divided into no complication group (n = 249), de novo SUI group (n = 68), and other complications group (n = 19). It seemed elder or obese women had a higher risk of de novo SUI after TVM (p < 0.05). In de novo SUI group, incidence of levator avulsion before surgery were higher than the other two groups (p = 0.001). TVM can significantly change a prolapse to point Aa and Ba on POP-Q quantification system (p < 0.05). RR ratios of de novo SUI with unilateral avulsion group is 2.60 (95% confidence interval [CI] 1.39-4.87), and 2.58 (95%CI 0.82-8.15) for bilateral group.

Conclusion: Unilateral levator avulsion, instead of bilateral levator avulsion, is a risk factor of de novo SUI after cystocele repair surgery.

Titel:	Unilateral levator avulsion increases the risk of de novo stress urinary incontinence after cystocele repair.
Autor/in / Beteiligte Person:	Hu, P ; Liu, L ; Dai, L ; Wang, Y ; Lei, L
Link:	Full Text Finder (Volltext)
Zeitschrift:	The journal of obstetrics and gynaecology research, Jg. 50 (2024-02-01), Heft 2, S. 245-252
Veröffentlichung:	[Melbourne, Vic. : Wiley on behalf of the Japan Society of Obstetrics and Gynecology] ; <i>Original Publication</i>: Tokyo : University of Tokyo Press, c1996-, 2024
Medientyp:	academicJournal
ISSN:	1447-0756 (electronic)
DOI:	10.1111/jog.15799
Schlagwort:	Humans Female Pregnancy Aged Colpotomy Risk Factors Surgical Mesh adverse effects Urinary Incontinence, Stress epidemiology Urinary Incontinence, Stress etiology Urinary Incontinence, Stress surgery Pelvic Organ Prolapse surgery Cystocele surgery Cystocele complications
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [J Obstet Gynaecol Res] 2024 Feb; Vol. 50 (2), pp. 245-252. <i>Date of Electronic Publication: </i>2023 Oct 10. MeSH Terms: Urinary Incontinence, Stress* / epidemiology ; Urinary Incontinence, Stress* / etiology ; Urinary Incontinence, Stress* / surgery ; Pelvic Organ Prolapse* / surgery ; Cystocele* / surgery ; Cystocele* / complications ; Humans ; Female ; Pregnancy ; Aged ; Colpotomy ; Risk Factors ; Surgical Mesh / adverse effects References: Rapp DE, King AB, Rowe B, Wolters JP. Comprehensive evaluation of anterior elevate system for the treatment of anterior and apical pelvic floor descent: 2-year follow up. J Urol. 2014;191(2):389-394. ; Nakai K, Hamuro A, Kitada K, Tahara M, Misugi T, Nakano A, et al. Preliminary evaluation of the short-term outcomes of polytetrafluoroethylene mesh for pelvic organ prolapse. 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Unilateral levator avulsion increases the risk of de novo stress urinary incontinence after cystocele repair.