title: Minimum 1.5-year results of "surgeon-tailored" transvaginal mesh repair for female stress urinary incontinence and pelvic organ prolapse.
abstract: OBJECTIVE
  To evaluate our minimum 1.5-year results with "surgeon-tailored" polypropylene mesh (STPM) in stress urinary incontinence treatment and the impact of concomitant pelvic organ prolapse repair on functional outcomes.
  
  
  METHODS
  All patients who were treated for stress urinary incontinence and pelvic organ prolapse using STPM between 2006 and 2010 were reviewed. Fifty-two patients received transobturator midurethral sling alone. Concomitant pelvic organ prolapse repair was performed in 74 (67 cystocele, 14 rectocele). Pre- and postoperative evaluation included subjective assessment of the impact of voiding and prolapse symptoms with International Consultation on Incontinence-Short Form and Prolapse Quality of Life (P-QOL) questionnaires, uroflowmetry, and urodynamic studies when necessary. Surgical outcomes at the last follow-up and complications were compared between the transobturator midurethral sling and transobturator midurethral sling + pelvic organ prolapse repair groups.
  
  
  RESULTS
  One-hundred eighteen women were available for analysis. With a mean follow-up of 33.4 and 41.2 months for transobturator midurethral sling and transobturator midurethral sling + pelvic organ prolapse repair groups, stress urinary incontinence was cured in 86.4% and 81.1% of the patients, respectively. Preoperative urge symptoms resolved in 53.8% and 62.5%, and de novo urge symptoms developed in 22% and 15% of patients with respect to study groups. Pelvic organ prolapse was cured in 98.6% patients, with a significant improvement in all domains of the P-QOL questionnaire at the last follow-up. Vaginal mesh erosions were detected in 11 (14.8%) patients with concomitant pelvic organ prolapse repair.
  
  
  CONCLUSIONS
  STPM may represent a cost-effective option for stress urinary incontinence treatment. Concomitant pelvic organ prolapse repair with STPM does not affect incontinence outcomes and provides high anatomic success and patient satisfaction in the long term. However, mesh-related complications with this approach is a major concern that deserves further investigation of risk factors and better definition of patient selection criteria.
authors.affiliation: Ümraniye Training and Research Hospital, Clinic of Urology, Istanbul, Turkey. ffonol@yahoo.com
authors.forename: Fikret Fatih
authors.initials: FF
authors.lastname: Önol
authors.forename: Fettah
authors.initials: F
authors.lastname: Tosun
authors.forename: Rasim
authors.initials: R
authors.lastname: Güzel
authors.forename: Uğur
authors.initials: U
authors.lastname: Boylu
authors.forename: Eyüp Veli
authors.initials: EV
authors.lastname: Küçük
authors.forename: Eyüp
authors.initials: E
authors.lastname: Gümüş
mesh_terms: D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011126:Polypropylenes; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods
chemical_list: D011126:Polypropylenes