title: Stress urinary incontinence after transobturator mesh for cystocele repair.
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.
authors.affiliation: Department of Obstetrics and Gynaecology, Nepean Clinical School, University of Sydney Nepean Hospital, Penrith, NSW 2750, Australia.
authors.forename: K L
authors.initials: KL
authors.lastname: Shek
authors.forename: A
authors.initials: A
authors.lastname: Rane
authors.forename: J
authors.initials: J
authors.lastname: Goh
authors.forename: H P
authors.initials: HP
authors.lastname: Dietz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052858:Cystocele / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology*