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.

OBJECTIVE

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).

METHODS

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.

RESULTS

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.

CONCLUSION

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.