Effects of anterior trocar guided transvaginal mesh surgery on lower urinary tract symptoms.
OBJECTIVE
To assess the effects of trocar guided transvaginal mesh on lower urinary tract symptoms after anterior vaginal wall prolapse repair.


METHODS
One hundred twenty-one patients undergoing anterior transvaginal mesh surgery was prospectively evaluated at baseline and 1 year after surgery using the urogenital distress inventory (UDI).


RESULTS
Overall UDI scores declined from 91 before surgery to 31 one year after surgery (P < 0.001). UDI subscales for obstructive and irritative symptoms improved 1 year after surgery (P < 0.001 for both) while stress symptoms did not (P = 0.11).


CONCLUSIONS
Trocar guided transvaginal mesh surgery for anterior vaginal wall prolapse was associated with an overall resolution of most symptoms associated with overactive bladder syndrome and bladder outlet obstruction. These beneficial effects should be weighed against an increased risk for stress urinary incontinence related to the procedure.
Division of Obstetrics and Gynaecology, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. marion.ek@sodersjukhuset.se
Marion
M
Ek
Daniel
D
Altman
Christian
C
Falconer
Sigurd
S
Kulseng-Hanssen
Gunilla
G
Tegerstedt
D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries; D013525:Surgical Instruments; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D053201:Urinary Bladder, Overactive / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics; D014570:Urologic Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D014596:Uterine Prolapse / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014621:Vagina / Q000601:surgery*