Comparison of Urinary Incontinence Occurrence Among Patients With Advanced Pelvic Organ Prolapse After Single Incision Mesh (SIM) and Anterior Mesh (A-Mesh) With Sacrospinous Ligament Fixation (SSF) Surgery at 1 Year Follow-Up Study.

Abstract

<h4>Objective</h4>We aimed to study the incidence of de novo and persistent stress urinary incontinence (SUI), urodynamic stress incontinence (USI) for single incision mesh (SIM) using Calistar-S and anterior mesh (A-mesh) using Surelift-A with sacrospinous fixation (SSF).<h4>Methods</h4>Patients with Stage III or IV POP who underwent Surelift-A + SSF (A-mesh + SSF) or Calistar-S (SIM) were evaluated at 1 year post-operative and compared. The primary outcome was the emergence of post-operative de novo and persistent SUI. Secondary outcomes included the rate of POP recurrence, quality of life, sexual function, and complications.<h4>Results</h4>One hundred and seven patients underwent SIM and 122 patients with A-mesh + SSF. 12/58 (20.7%) had de novo USI, 15/58 (25.9%) de novo SUI in SIM, while in the A-mesh + SSF group, de novo USI developed in 3/43 (7%) and de novo SUI in 4/43 (9.3%), significantly higher with p = 0.048 and p = 0.035 respectively. Rates of persistent USI and SUI were comparable between groups. Objective cure was comparable between the two groups (96.3% vs. 97.5%, p = 0.428), subjective cure 99/107 (92%) vs. 114/122 (93.8%) for SIM vs. A-mesh + SSF. Quality-of-life measures improved significantly in both groups, with greater perceived improvement in the A-mesh + SSF group. One case of bladder injury occurred in SIM and one mesh erosion was seen in both groups.<h4>Conclusion</h4>Risk of de novo SUI and de novo USI were three-fold higher in the SIM (Calistar-S), however risk of persistent USI and SUI was similar. Both SIM and A-mesh + SSF confer comparable high objective and subjective cure.