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04-05-2024 | Stress Incontinence | Original Article

Midurethral Sling Mesh Exposure Confers a High Risk of Persistent Stress Urinary Incontinence

Authors: Tamara Siblini, Michael Baracy, Sanjana Kulkarni, Colton Mabis, Karen Hagglund, Muhammad Aslam

Published in: International Urogynecology Journal

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Abstract

Introduction and hypothesis

The objective was to investigate the relationship between mesh exposure and persistent stress urinary incontinence (SUI) post-midurethral sling (MUS) surgery.

Methods

Extensive data collection including patient demographics, obstetric history, existing medical conditions, previous surgeries, and surgical outcomes, encompassing both perioperative and postoperative complications.

Results

Out of 456 patients who underwent the MUS procedure within the specified period, the persistence of SUI was noted in 6.4% of cases. Mesh exposure was observed in 8.8% of these cases. Notably, 25% of patients with mesh exposure suffered from persistent SUI, in stark contrast to 4.6% of those without mesh exposure (p < 0.0001). Further, multivariate analysis indicated that patients with mesh exposure had an approximately 6.5-fold increased likelihood (95% CI: 2.71—15.44) of experiencing persistent SUI compared with those without mesh exposure.

Conclusions

Mesh exposure is a significant independent risk factor for persistent SUI post-MUS surgery. Patients with mesh exposure are about 6.5 times more prone to persistent SUI than those without. Although mesh exposure is typically managed with expectant measures, vaginal estrogen or mesh excision, current evidence does not support surgical revision of MUS affected by mesh exposure or additional incontinence procedures during mesh excision.
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Metadata
Title
Midurethral Sling Mesh Exposure Confers a High Risk of Persistent Stress Urinary Incontinence
Authors
Tamara Siblini
Michael Baracy
Sanjana Kulkarni
Colton Mabis
Karen Hagglund
Muhammad Aslam
Publication date
04-05-2024
Publisher
Springer International Publishing
Published in
International Urogynecology Journal
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-024-05762-y