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Medium‐term outcomes for primary native tissue reconstructive surgeries with and without transobturator vaginal meshes in stress continent women with stage 3 or higher pelvic organ prolapse
Author(s) -
Huang WenChen,
Yang JennMing,
Chen HsinFu
Publication year - 2020
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24186
Subject(s) - medicine , pelvic floor , stage (stratigraphy) , native tissue , reconstructive surgery , term (time) , surgery , tissue engineering , paleontology , biology , physics , quantum mechanics , biomedical engineering
Aims To compare the surgical outcomes of conventional surgeries with or without concomitant transobturator vaginal mesh (TVM) for ≥Stage 3 pelvic organ prolapse (POP). Methods We retrospectively investigated 166 women who received conventional surgery including vaginal total hysterectomy, modified McCall culdoplasty, and AP‐repair (conventional group) and 98 women with concomitant TVM (mesh group). Follow‐up at 3, 12, and 24 months comprised symptom interview, pelvic examination, and ultrasound assessments. The primary outcome was anatomical success defined as ≤Stage 1 POP. Secondary outcomes were subjective symptoms, ultrasound manifestations, and complications. Results Both groups showed improvements in functional and anatomical outcomes after operations. Compared with the conventional group, the mesh group had higher rates of de novo stress urinary incontinence (SUI) at 3‐month (3.6% vs 19.4%; P < .001), 12‐month (3.7% vs 26.4%; P < .001), and 24‐month (2.4% vs 21.4%; P = .001) follow‐up, a higher POP‐C point (−7.3 ± 0.7 cm vs −7.6 ± 0.6 cm; P < .001) at 3‐month follow‐up, a smaller straining bladder neck angle indicating a more cranioventral straining bladder neck position (117 ± 25° vs 102 ± 20°; P < .001) at 3‐month follow‐up, and a less bladder neck mobility at 3‐month (19 ± 24° vs 8 ± 14°; P = .002) and 12‐month (26 ± 18° vs 12 ± 15°; P = .003) follow‐up. Conclusions Concomitant TVM is associated with a higher rate of de novo SUI, more cranioventral straining bladder neck position, and less bladder neck mobility.