Can the suburethral mesh angle be used to predict trans-obturator tape results?
PURPOSE: The primary aim of our study was to evaluate mesh movement on ultrasonography and to compare the relationship between suburethral mesh angle and incontinence recurrence.


METHODS
This study was carried out at the University of Selcuk, Konya, Turkey, Beyhekim State Hospital, Konya, Turkey and the Mus State Hospital between September 2012 and January 2015. In total, the results from 109 patients were evaluated in the statistical analysis. The suburethral mesh angle (SMA) is the angle between the two arms of the trans-obturator tape (TOT) mesh under the urethra. This angle was measured at 10 days, 6 months and 1 year after surgery. Potential risk factors for incontinence recurrence and SMA were compared in logistic regression models. The best cut-off value for SMA was calculated to predict incontinence recurrence.


RESULTS
The mean resting SMA did not change with time during follow-up (p = 0.373). However, when comparing coughing SMA values, the first day measurement was significantly different from the other measurements. Another comparison was performed according to the cSMA value at each visit. The difference was significant from the first day. Lung disease and the change in the SMA (cSMA) on day 10 were significant predictors of treatment failure. The cSMA on day 10 to predict first-year treatment failure was 10°, with 61% sensitivity and 96% specificity.


CONCLUSIONS
Measurement of the SMA can be used as a prognostic factor in TOT surgery. Further research is required to determine the importance of SMA as a prognostic factor.
Department of Gynecology and Obstetrics, Selcuk University, Aladdin Keykubat Campus, Konya, Turkey. tolgaytuyan@yahoo.com.
Tolgay Tuyan
TT
Ilhan
Beyhekim State Hospital, Konya, Turkey.
Türkan Saymaz
TS
Ilhan
Department of Gynecology and Obstetrics, Selcuk University, Aladdin Keykubat Campus, Konya, Turkey.
Mustafa Gazi
MG
Ucar
Department of Gynecology and Obstetrics, Selcuk University, Aladdin Keykubat Campus, Konya, Turkey.
Ayşegül
A
Kebapçılar
Muş State Hospital, Muş, Turkey.
Mithat
M
Kıvrık
Department of Gynecology and Obstetrics, Selcuk University, Aladdin Keykubat Campus, Konya, Turkey.
Çetin
Ç
Çelik
D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D053825:Suburethral Slings; D013526:Surgical Mesh; D017211:Treatment Failure; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
Incontinence surgery; Mesh movement; Stress urinary incontinence; Treatment failure