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Stress urinary incontinence after transobturator mesh for cystocele repair
1Department of Obstetrics and Gynaecology, Nepean Clinical School, University of Sydney Nepean Hospital, Penrith, NSW 2750, Australia.
Abstract:
Cystocele repair can lead to de novo stress urinary incontinence (SUI) or exacerbate pre-existing SUI. This study was designed to determine the effect of cystocele repair by transobturator mesh on SUI. In a retrospective observational study, we saw 93 patients after a transobturator mesh procedure. Of those, 57 women had not undergone a concomitant anti-incontinence procedure. We analyzed their clinical data and ultrasound datasets. At a median follow-up of 9 months, 21 of 24 preoperatively stress incontinent women reported cure/improvement, one patient reported worsened SUI. Seven of 33 preoperatively continent women complained of de novo SUI. There is a net positive effect on SUI (McNemar chi(2) exact test p = 0.013) after transobturator mesh. A narrower gap between symphysis pubis and mesh was associated with a positive outcome (p = 0.015 on ANOVA). Transobturator mesh for cystocele repair appears to have a net positive effect on SUI.
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