Failure to Adjust Mesh Length Beneath the Bladder Is an Independent Factor of Postoperative Urinary Incontinence After Transvaginal Mesh Surgery.

Abstract

<h4>Purpose</h4>Urinary incontinence is a problematic complication after surgery for pelvic organ prolapse including transvaginal mesh surgery (TVM). Japan's only mesh product available for TVM, ORIHIME, is known to easily slide off the anchored tissue, which may lead to recurrence and/or urinary incontinence. In this study, we investigated which factors that contribute to urinary incontinence following TVM using ORIHIME.<h4>Methods</h4>The study enrolled 102 patients who underwent TVM at our hospital between July 2019 and March 2023. The Pearson chi-square test, multiple logistic regression analysis, and the Cox proportional hazards model were used to determine independent factors contributing to postsurgical urinary incontinence.<h4>Results</h4>The Pearson chi-square test showed that the presence of diabetes mellitus (DM) and the adjustment of the mesh length beneath the bladder significantly correlated with postoperative urinary incontinence among preoperative and intraoperative factors (both P<0.05). The presence of DM and the adjustment of the mesh length beneath the bladder were also significant factors in both univariate and multivariate analyses of multiple logistic regression analysis (both P<0.05). In addition, these variables acted as independent factors for shorter time to postoperative urinary incontinence in the multivariate analysis of the Cox proportional hazards model (hazard ratio, 4.99 and 6.63, respectively).<h4>Conclusion</h4>The mesh size adjusted to the length from the cervix to the bladder neck should be considered to avoid postoperative urinary incontinence in TVM using ORIHIME.