A new treatment of female stress urinary incontinence with vaginal antetheca–retropubic space mesh repair surgery: a clinical trial
- 118 Downloads
To investigate the short- and medium-term effect of vaginal antetheca submucosal-retropubic space with mesh repair through the implantation of organic patch (shortly as new-style vaginal mesh repair) in the treatment of patients with stress urinary incontinence (SUI).
This was a clinical prospective single arm study in a tertiary grade hospital (General Hospital of Jinan Military Region, Jinan, China). From January 2009 to December 2014, 316 female patients were enrolled. 316 female patients with stress urinary incontinence (SUI) underwent the surgery. The treatment effect was evaluated using the urinary incontinence questionnaire (ICIQ-SF), urine pad test and coughing test. The perioperative and postoperative complications were also evaluated. The results were compared with 1-year cure rates of Burch retropubic urethropexy (Burch) and tension-free vaginal tape (TVT) procedure.
The mean follow-up period was 25 ± 12 months. The success rate of the new surgical technique was 94.0% (297/316) at 1 month, and 91.5% (289/316) at 1-year postoperation. The ICIQ-SF score significantly decreased at the 1-year follow-up (P < 0.01). There was no significant difference in the 1-year cure rate when compared with the Burch and TVT procedures (P > 0.05). The rates of perioperative urinary tract irritation and mesh exposure were 9.5% (30/316) and 5.38% (17/316), respectively, and no serious complications were found.
The surgery demonstrated favorable short-term and medium-term treatment effects. Given its advantages of being minimally invasive, cost efficient and requiring only local anesthesia, this new surgical technique has a potential for broader clinical application.
KeywordsStress urinary incontinence New vaginal anterior wall mesh repair Minimally invasive surgery Efficacy
GP Yin: protocol/project development, data collection and manuscript writing. Z Yuan: data collection. J Li: data management. J Liang, AF Wu, and N Liu: data analysis.
Compliance with ethical standards
Conflict of interest
None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Zhang L, Zhu L, Xu T, Lang J, Li Z, Gong J, Liu Q, Liu X (2015) A population-based survey of the prevalence, potential risk factors, and symptom-specific bother of lower urinary tract symptoms in adult Chinese women. Eur Urol 68(1):97–112. https://doi.org/10.1016/j.eururo.2014.12.012 CrossRefPubMedGoogle Scholar
- 5.Ghanbari Z, Hajibaratali B, Shariat M (2007) Comparison of tension-free vaginal tape versus transobturator tape in women with stress urinary incontinence. Astron Astrophys 325(1):360–366Google Scholar
- 8.Zhen-Hua GU, Liu DM, Chen Q (2006) The clinical utilization of laparoscopic Burch operation in treatment of stress urinary incontinence. J Laparosc Surg 23(4):379Google Scholar
- 10.Wagg A, Gibson W, Ostaszkiewicz J, Johnson T 3rd, Markland A, Palmer MH, Kuchel G, Szonyi G, Kirschner-Hermanns R (2015) Urinary incontinence in frail elderly persons: report from the 5th International Consultation on Incontinence. Neurourol Urodyn 34(5):398–406. https://doi.org/10.1002/nau.22602 CrossRefPubMedGoogle Scholar
- 11.National Collaborating Centre for Women’s and Children’s Health (2013) In: Urinary Incontinence in women: the management of urinary incontinence in women. national institute for health and care excellence: Clinical guidelines. Royal College of Obstetricians and Gynaecologists (UK), LondonGoogle Scholar
- 12.Reisenauer C, Muche-Borowski C, Anthuber C, Finas D, Fink T, Gabriel B, Hubner M, Lobodasch K, Naumann G, Peschers U, Petri E, Schwertner-Tiepelmann N, Soeder S, Steigerwald U, Strauss A, Tunn R, Viereck V, Aigmuller T, Kolle D, Kropshofer S, Tamussino K, Kuhn A, Hofner PD, Kirschner-Hermanns R, Oelke M, Schultz-Lampel D, Klingler C, Henscher U, Kowing A, Junginger B (2013) Interdisciplinary S2e guideline for the diagnosis and treatment of stress urinary incontinence in women: short version—AWMF Registry No. 015-005, July 2013. Geburtshilfe Frauenheilkd 73(9):899–903. https://doi.org/10.1055/s-0033-1350871 CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Haylen BT, Freeman RM, Lee J, Swift SE, Cosson M, Deprest J, Dwyer PL, Fatton B, Kocjancic E, Maher C, Petri E, Rizk DE, Schaer GN, Webb R (2012) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related to native tissue female pelvic floor surgery. Int Urogynecol J 23(5):515–526. https://doi.org/10.1007/s00192-011-1659-x CrossRefPubMedGoogle Scholar
- 14.Zhang WY, Hu H, Wang Q, Chen JW, Xu KX (2016) Significance of preoperative urodynamics for clinical diagnosis of female patients with stress urinary incontinence. J Peking Univ Health Sci 48(1):655–658Google Scholar
- 16.Abrams P, Avery K, Gardener N, Donovan J, Board IA (2006) The International Consultation on Incontinence Modular Questionnaire. J Urol 175 (3 Pt 1):1063–1066. www.iciq.net (discussion 1066)
- 18.Chai TC, Richter HE, Moalli P, Keay S, Biggio J, Zong W, Curto T, Kim HY, Stoddard AM, Kusek JW (2014) Inflammatory and tissue remodeling urinary biomarkers before and after mid urethral sling surgery for stress urinary incontinence. J Urol 191(3):703–709. https://doi.org/10.1016/j.juro.2013.10.051 CrossRefPubMedGoogle Scholar
- 19.Azadi A, Jasinski JB, Francis SL, Pasic R, Lipetskaia L, Deveneau NE, Yeganeh T, Ostergard DR (2014) Evaluation of surgical instrument handling on polypropylene mesh using scanning electron microscopy. Int Urogynecol J 25(5):651–656. https://doi.org/10.1007/s00192-013-2271-z CrossRefPubMedGoogle Scholar
- 20.Karateke A, Haliloglu B, Cam C, Sakalli M (2009) Comparison of TVT and TVT-O in patients with stress urinary incontinence: short-term cure rates and factors influencing the outcome. A prospective randomised study. Aust NZ J Obstet Gynaecol 49(1):99–105. https://doi.org/10.1111/j.1479-828X.2009.00957.x CrossRefGoogle Scholar