Anterior-apical single-incision mesh surgery (uphold): 1-year outcomes on lower urinary tract symptoms, anatomy and ultrasonography
- 81 Downloads
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.
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.
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.
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.
KeywordsAnterior apical mesh Outcome Ultrasonography
Compliance with ethical standards
Conflicts of interest
- 1.Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;4:CD004014.Google Scholar
- 6.Wong V, Shek KL, Rane A, Lee J, Rosamilia A. Dietz HP. A comparison of two different mesh kit systems for anterior compartment prolapse repair. Aust N Z J Obstet Gynaecol. 2014;54(3):212–7.Google Scholar
- 7.Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(1):5–26.CrossRefPubMedGoogle Scholar
- 8.Shumaker SAWJ, Uebersax JS, McClish D, Fantl JA. Health-related quality of life measures for women with urinary incontinence: the incontinence impact questionnaire and the urogenital distress inventory. Continence program in women (CPW) research group. Qual Life Res. 1994;3(5):291–306.CrossRefPubMedGoogle Scholar
- 12.Letouzey V, Ulrich D, Balenbois E, Cornille A, de Tayrac R, Fatton B. Utero-vaginal suspension using bilateral vaginal anterior sacrospinous fixation with mesh: intermediate results of a cohort study. Int Urogynecol J 2015;26(12):1803–1807.Google Scholar
- 17.Vu MK, Letko J, Jirschele K, Gafni-Kane A, Nguyen A, Du H, et al. Minimal mesh repair for apical and anterior prolapse: initial anatomical and subjective outcomes. Int Urogynecol J. 2012;23:1753–61.Google Scholar