To evaluate the changes in clinical outcome and urodynamic parameters after tailored anterior transvaginal mesh (ATVM) surgeries in a mid-term follow-up.
Between November 2011 and December 2015, women with ≥stage II pelvic organ prolapse (POP) who underwent ATVM surgeries were retrospectively reviewed. The data-reviewing timeframe was until December 2021. Clinical and urodynamic diagnoses regarding urinary symptoms were evaluated before and after the operation.
A total of 160 women were included. Stress urinary incontinence decreased significantly after the operation (99% (159/160) vs. 43% (68/160), p < 0.01), as well as the pad weight (20.5 ± 2.7 vs. 9.4 ± 2.0, p < 0.001) and diagnosis of urodynamic stress incontinence (83% (132/160) vs. 51% (82/160), p < 0.01). Overactive bladder syndrome increased significantly after the operation (18% (29/160) vs. 28% (45/160), p = 0.03), even though the objective parameters, such as first and strong desire to void, bladder oversensitivity, and detrusor overactivity, were all improved after the operation. The pad weight was mostly improved significantly within the first postoperative 2 years. Eighteen (11%) women had global recurrent POP, and only one (0.6%) woman had true recurrence of cystocele. Twenty-four (15%) women had mesh extrusion, and two-thirds of them could be managed in an office setting.
In women with advanced cystocele, the ATVM surgery provides a favorable anatomic reduction outcome with an acceptable mesh extrusion rate. The ATVM provides an anti-incontinence effect, both in subjective symptoms and objective parameters, but this effect might decline after postoperative 2 years.
Journal of the Formosan Medical Association = Taiwan yi zhi. 2022 Aug 17 [Epub ahead of print]
Pei-Chi Wu, Sheng-Mou Hsiao, Ting-Chen Chang, Chi-Hau Chen, Ho-Hsiung Lin
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan., Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan., Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan. Electronic address: .