An modified vaginal mesh procedure for the female persistent or recurrent stress urinary incontinence after initial synthetic mid-urethral slings operation / 中华泌尿外科杂志

ABSTRACT

Objective The aim of study is to evaluate the efficacy of a new complementary midurethral sling surgery in treating recurrent or persist female stress urinary incontinence (SUI) after primary Synthetic mid-urethral slings (MUSs).Methods The methods was used in 32 patients who had suffered recurrent or persist SUI patients after primary MUSs during June 2005 and July 2011.Their primary MUSs wereTVT 2 cases,IVS 4 cases,TVT-O 17 cases,TOT 3 cases,T-sling 1case,other MUSs 5 cases.9 cases complained SUI symptoms continued after primary surgery and had no improvement after 6 months following up.23 cases reported SUI symptoms recurrent and aggravated in 6 months after primary operation and had no improvement 1 year after operation.All these patients have been treated with surgery,a trans-vaginal mid-urethral sling on descending pubic ramus.In this study we followed up these patients for one year after this complementary operation and evaluated operating time,blood loss,efficacy and complications.Results In this study the operating time was 41.1±13.1 minutes,blood loss was 70.6±23.8 ml.30 patients kept urinary catheter 6 h after operation and 2 kept urinary catheter 48 h after operation.All patients could micturate after removed urinary catheter and average residual urine was 23.8 ± 21.4 ml (range 0-80 ml).The average in-patients duration was 4.8± 1.1days.SUI symptoms still persisted in two patients after second operation,subjective cure was achieved in 26 patients and the symptoms obviously improved in 4 patients when they left hospital.The efficient rate was 93.8％ (30/32) left hospital and after 3 months,93.3％ (28/30) after 6 months and 86.2％ (25/29) after 1 year.There were 2 cases of recurrence and 1 case of mesh erosion after 1 year,no other operative complications were reported.Conclusions Our study found that it is a efficient operation to treat SUI recur or persist after primary.