Does a midurethral sling inserted at the time of pelvic organ prolapse mesh surgery increase the rate of de novo OAB? A prospective longitudinal study

• Published in: Ginekologia polska 2014-09, Vol.85 (9), p.652-657
• Main Authors: Futyma, Konrad, Miotła, Paweł, Bartuzi, Aleksandra, Winkler, Izabela, Lis, Ernest, Kulik-Rechberger, Beata, Rechberger, Tomasz
• Format: Article
• Language: English
• Subjects: Adult; Aged; Female; Follow-Up Studies; Humans; Longitudinal Studies; Middle Aged; Patient Satisfaction; Pelvic organ prolapse; Pelvic Organ Prolapse - surgery; Prospective Studies; Suburethral Slings - adverse effects; Surgery; Surgical Mesh - adverse effects; Treatment Outcome; Urinary Bladder, Overactive - etiology; Urinary Bladder, Overactive - prevention & control; Urinary incontinence; Urinary Incontinence, Urge - etiology; Urinary Incontinence, Urge - prevention & control; Urodynamics
• ISSN: 0017-0011; 0017-0011; 2543-6767
• DOI: 10.17772/gp/1787

Approximately 20% of women suffer from pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Furthermore, POP and overactive bladder (OAB) symptoms often coexist. Midurethral slings and mesh surgeries are both considered to be risk factors for de novo OAB symptoms. The aim of our study was to determine whether simultaneous midurethral sling insertion at the time of pelvic organ prolapse mesh surgery further increases the risk of de novo OAB. The study group consisted of 234 women who underwent surgery in our department between August 2007 and October 2009 (114 patients underwent surgery because of coexisting POP and SUI, and 120 underwent surgery because POP alone). The patients were evaluated at follow-up visits scheduled after 6-8 weeks and after 12 months. All women underwent surgery using the Gynecare Prolift Pelvic Floor Repair System, whereas in women with additional overt or occult SUI after restoration of the pelvic anatomy monofilament midurethral slings were simultaneously inserted. The chi-squared test was used to compare the study groups. De novo OAB symptoms were significantly more pronounced among women in the Prolift only surgery group (23.3%) compared to the Prolift with IVS04M group (10.5%; p = 0.0093). Midurethral sling insertion at the time of pelvic organ prolapse surgery significantly decreases the rate of postoperative de novo OAB symptoms. The lack of anatomical success of the mesh-based reconstructive surgery is a risk factor for the development of de novo OAB symptoms.