title: Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome.
abstract: BACKGROUND
  To clinically and sonographically evaluate the influence of anterior vaginal mesh (AVM) surgery with concomitant mid-urethral sling surgery (MUS) for stress urinary incontinence (SUI).
  
  
  METHODS
  Women with severe symptomatic pelvic organ prolapse (POP) stage III or IV with concomitant SUI were divided into two groups: Group I had transobturator tape (TOT) and AVM surgery and Group II underwent TOT without AVM surgery. Clinical outcome was assessed pre-operatively and 1 year post-operatively, while ultrasound evaluations were performed after one year. Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry. Subjective SUI cure was a negative response to Urogenital Distress Inventory Six (UDI-6) (question 3).
  
  
  RESULTS
  A total of 97 women were recruited, 57 in Group I and 40 in Group II. Three women had symptomatic prolapse in Group I and 5 in Group II. There were no differences in the ultrasound and clinical outcomes between women who had mid-urethral slings with and without AVM. Successful SUI outcome was reported in 85 women. Urethral kinking was demonstrable in 50% of successful cases, but none with failed outcomes. Subanalysis among those with successful SUI outcome (n = 85) and failure (n = 12) revealed the tape, bladder neck and mesh mobility was significantly higher (P < 0.001) among those with SUI success.
  
  
  CONCLUSIONS
  Among women who had MUS, there were no differences in the ultrasound and clinical outcome between those who had AVM or otherwise.
authors: Department of Obstetrics and Gynecology, Keelung and Taipei, Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan.|Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Tsia-Shu
authors: TS
authors: Lo
authors: Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.|Department of Obstetrics & Gynecology, Kuching Specialist Hospital, KPJ, Sarawak, Malaysia.
authors: Yiap Loong
authors: YL
authors: Tan
authors: Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.|Department of Obstetrics & Gynecology, De La Salle University Medical Center, Dasmariñas, Cavite, Philippines.
authors: Eileen Feliz Mendoza
authors: EF
authors: Cortes
authors: Linkou Medical Center, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Yi-Hao
authors: YH
authors: Lin
authors: Department of Obstetrics and Gynecology, Keelung and Taipei, Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan.|Linkou Medical Center, Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Pei-Ying
authors: PY
authors: Wu
authors: Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.|Department of Obstetrics & Gynecology, Hospital Serdang, Kajang, Selangor, Malaysia.
authors: Leng Boi
authors: LB
authors: Pue
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D053825:Suburethral Slings; D013526:Surgical Mesh; D017211:Treatment Failure; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: mid-urethral sling; pelvic organ prolapse; stress incontinence; transvaginal mesh; ultrasound