De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair

Am J Obstet Gynecol. 2009 Jul;201(1):73.e1-7. doi: 10.1016/j.ajog.2009.02.028. Epub 2009 Apr 23.

Abstract

Objective: We sought to determine the rate of de novo stress incontinence, pelvic muscle symptoms, mesh exposure, visceral injury rate, and recurrent prolapse after transvaginal mesh repair.

Study design: We conducted a retrospective review of 335 consecutive women with stage II or worse vaginal prolapse who underwent Prolift (Ethicon, Somerville, NJ) between July 7, 2005 and Jan. 31, 2008.

Results: In all, 71% underwent total Prolift, 20% anterior, and 8% posterior alone. Average age was 62 years and mean follow-up was 8 months. The intraoperative visceral injury rate was 6.6%, mesh exposure rate was 3.8%, and recurrent failure rate was 5.2%. The postoperative de novo stress incontinence rate was 24.3%. In this series, 18% of women had pelvic muscle symptoms postoperatively; 74% of these resolved within 6 months with conservative management.

Conclusion: After Prolift, surgeons can expect a low rate of recurrent prolapse and mesh exposure. However, pelvic muscle dysfunction and de novo stress incontinence will be encountered postoperatively in a moderate number of women.

MeSH terms

  • Adult
  • Aged
  • Dyspareunia / etiology
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Intraoperative Complications / epidemiology
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Prostheses and Implants
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh*
  • Urinary Incontinence, Stress / epidemiology*
  • Urinary Incontinence, Stress / physiopathology
  • Urodynamics
  • Uterine Prolapse / surgery*