Unilateral levator avulsion increases the risk of de novo stress urinary incontinence after cystocele repair.

Autor: Hu P; Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China.; Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China., Liu L; Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China.; Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China., Dai L; Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China.; Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China., Wang Y; Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China.; Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China., Lei L; Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China.; Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
Jazyk: angličtina
Zdroj: The journal of obstetrics and gynaecology research [J Obstet Gynaecol Res] 2024 Feb; Vol. 50 (2), pp. 245-252. Date of Electronic Publication: 2023 Oct 10.
DOI: 10.1111/jog.15799
Abstrakt: Introduction: Patients without concurrent baseline stress urinary incontinence (SUI) can develop de novo SUI after transvaginal mesh surgery (TVM) for cystocele repair. Surgeons should be aware of de novo SUI risk factors after TVM.
Methods: A total of 1124 women who were underwent TVM surgeries were recruited and assessed for eligibility from January 1, 2012 to April 30, 2021. All data related to patients and surgeries was collected, which included general conditions, clinical examination, surgery records, and follow-up results. Patients were divided into three groups according to follow-up results and data were compared with each group. The relative risk (RR) of de novo SUI with levator avulsion was also calculated.
Results: Three hundred thirty-six patients were included in this study. They were divided into no complication group (n = 249), de novo SUI group (n = 68), and other complications group (n = 19). It seemed elder or obese women had a higher risk of de novo SUI after TVM (p < 0.05). In de novo SUI group, incidence of levator avulsion before surgery were higher than the other two groups (p = 0.001). TVM can significantly change a prolapse to point Aa and Ba on POP-Q quantification system (p < 0.05). RR ratios of de novo SUI with unilateral avulsion group is 2.60 (95% confidence interval [CI] 1.39-4.87), and 2.58 (95%CI 0.82-8.15) for bilateral group.
Conclusion: Unilateral levator avulsion, instead of bilateral levator avulsion, is a risk factor of de novo SUI after cystocele repair surgery.
(© 2023 Japan Society of Obstetrics and Gynecology.)
Databáze: MEDLINE
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