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Vol 85, No 9 (2014)
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Does a midurethral sling inserted at the time of pelvic organ prolapse mesh surgery increase the rate of de novo OAB? A prospective longitudinal study

Konrad Futyma, Paweł Miotła, Alkeksandra Bartuzi, Izabela Winkler, Ernest Lis, Tomasz Rechberger, Beata Kulik-Rechberger
DOI: 10.17772/gp/1787
·
Ginekol Pol 2014;85(9).

open access

Vol 85, No 9 (2014)
ARTICLES

Abstract

Objectives: Approximately 20% of women suffer from pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Furthermore, POP and overactive bladder (OAB) symptoms often coexist. Midurethral slings and mesh surgeries are both considered to be risk factors for de novo OAB symptoms. The aim of our study was to determine whether simultaneous midurethral sling insertion at the time of pelvic organ prolapse mesh surgery further increases the risk of de novo OAB. Materials and methods: The study group consisted of 234 women who underwent surgery in our department between August 2007 and October 2009 (114 patients underwent surgery because of coexisting POP and SUI, and 120 underwent surgery because POP alone). The patients were evaluated at follow-up visits scheduled after 6-8 weeks and after 12 months. All women underwent surgery using the Gynecare ProliftR Pelvic Floor Repair System, whereas in women with additional overt or occult SUI after restoration of the pelvic anatomy, monofilament midurethral slings were simultaneously inserted. The chi-squared test was used to compare the study groups. Results: De novo OAB symptoms were significantly more pronounced among women in the ProliftR only surgery group (23.3%) compared to the ProliftR with IVS04M group (10.5%; p=0.0093). Conclusions: Midurethral sling insertion at the time of pelvic organ prolapse surgery significantly decreases the rate of postoperative de novo OAB symptoms. The lack of anatomical success of the mesh-based reconstructive surgery is a risk factor for the development of de novo OAB symptoms.

Abstract

Objectives: Approximately 20% of women suffer from pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Furthermore, POP and overactive bladder (OAB) symptoms often coexist. Midurethral slings and mesh surgeries are both considered to be risk factors for de novo OAB symptoms. The aim of our study was to determine whether simultaneous midurethral sling insertion at the time of pelvic organ prolapse mesh surgery further increases the risk of de novo OAB. Materials and methods: The study group consisted of 234 women who underwent surgery in our department between August 2007 and October 2009 (114 patients underwent surgery because of coexisting POP and SUI, and 120 underwent surgery because POP alone). The patients were evaluated at follow-up visits scheduled after 6-8 weeks and after 12 months. All women underwent surgery using the Gynecare ProliftR Pelvic Floor Repair System, whereas in women with additional overt or occult SUI after restoration of the pelvic anatomy, monofilament midurethral slings were simultaneously inserted. The chi-squared test was used to compare the study groups. Results: De novo OAB symptoms were significantly more pronounced among women in the ProliftR only surgery group (23.3%) compared to the ProliftR with IVS04M group (10.5%; p=0.0093). Conclusions: Midurethral sling insertion at the time of pelvic organ prolapse surgery significantly decreases the rate of postoperative de novo OAB symptoms. The lack of anatomical success of the mesh-based reconstructive surgery is a risk factor for the development of de novo OAB symptoms.

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Keywords

anti-incontinence surgery, lower urinary tract symptoms, mesh surgery, Overactive Bladder, Pelvic organ prolapse, urinary incontinence

About this article
Title

Does a midurethral sling inserted at the time of pelvic organ prolapse mesh surgery increase the rate of de novo OAB? A prospective longitudinal study

Journal

Ginekologia Polska

Issue

Vol 85, No 9 (2014)

Page views

742

Article views/downloads

913

DOI

10.17772/gp/1787

Bibliographic record

Ginekol Pol 2014;85(9).

Keywords

anti-incontinence surgery
lower urinary tract symptoms
mesh surgery
Overactive Bladder
Pelvic organ prolapse
urinary incontinence

Authors

Konrad Futyma
Paweł Miotła
Alkeksandra Bartuzi
Izabela Winkler
Ernest Lis
Tomasz Rechberger
Beata Kulik-Rechberger

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