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Anterior-apical single-incision mesh surgery (uphold): 1-year outcomes on lower urinary tract symptoms, anatomy and ultrasonography

  • Tsia-Shu Lo
  • Leng Boi Pue
  • Yiap Loong Tan
  • Wu-Chiao Hsieh
  • Chuan Chi Kao
  • Ma. Clarissa Uy-Patrimonio
Original Article
  • 46 Downloads

Abstract

Introduction and hypothesis

Our primary objective is to determine the presence of SUI at 6–12 months after surgery. The secondary objective is to determine the objective and subjective outcomes of POP.

Methods

A retrospective study conducted between February 2015 and July 2016 at Chang Gung Memorial Hospital. The subjects had had symptomatic anterior or apical prolapse with stage III or IV and undergone pelvic reconstructive surgery using Uphold™ LITE. Patients completed a 3-day voiding diary, urodynamic study, real-time ultrasonography and validated quality-of-life questionnaires at baseline and 12-month follow-up. Primary outcome was the absence of USI. Secondary outcomes included the objective cure rate of POP, ≤ stage 1 at the anterior/apical vaginal wall, and the subjective cure rate, negative feedback to POPDI-6.

Results

Ninety-five women were eligible. Six were excluded because of incomplete data. The postoperative de novo USI and SUI were 22.7 and 19.7%, respectively. There was significant improvement of USI in patients who had MUS insertion (93.8%) and bladder outlet obstruction (96.7%). The objective and subjective cure rate for prolapse was 95.5 and 94.3%, respectively. POP-Q measurements pre- and postoperatively were significantly improved at all points except for Gh and Pb. There was a significant difference in the distance between the bladder neck to the distal end of the mesh during straining both at both the postoperative 3rd month and 1 year.

Conclusions

Uphold™ mesh has a 20% incidence of de novo USI with acceptable objective and subjective cure rates at 1 year postoperatively. The de novo USI rate was high but not bothersome enough to require surgery.

Keywords

Anterior apical mesh Outcome Ultrasonography 

Notes

Compliance with ethical standards

Conflicts of interest

None

Supplementary material

192_2018_3691_MOESM2_ESM.avi (13.2 mb)
Video 1 The dynamic movement of the mesh, tape and bladder neck at cough (AVI 13515 kb)

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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  • Tsia-Shu Lo
    • 1
    • 2
  • Leng Boi Pue
    • 3
  • Yiap Loong Tan
    • 4
  • Wu-Chiao Hsieh
    • 1
    • 2
  • Chuan Chi Kao
    • 1
  • Ma. Clarissa Uy-Patrimonio
    • 5
    • 6
  1. 1.Department of Obstetrics and Gynecology, Keelung, Medical CenterChang Gung Memorial HospitalKeelungRepublic of China
  2. 2.Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical CenterChang Gung Memorial HospitalTaoyuanRepublic of China
  3. 3.Department of Obstetrics & GynecologySubang Jaya Medical CentreSubang JayaMalaysia
  4. 4.Department of Obstetrics and GynecologyKuching Specialist HospitalSarawakMalaysia
  5. 5.Fellow, Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical CenterChang Gung Memorial HospitalTaoyuanRepublic of China
  6. 6.Department of Obstetrics and GynecologyDr. Pablo O. Torre Memorial HospitalBacolod CityPhilippines

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