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The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously - results controlled with a pelvic floor ultrasound. A preliminary study.

Abstract：

OBJECTIVES:It is controversial whether pelvic organ prolapse and stress urinary incontinence (SUI) should be treated simultaneously with a single surgery or separately with two procedures. The pre-pubic four-arm NAZCA-TC® mesh was invented to treat cystocele and SUI with a single procedure. The objective of this study is to analyze short-term results after the implantation of NAZCA-TC mesh. MATERIAL AND METHODS:A total of 18 women underwent the evaluation of results of mesh implantation within a 24 to 36 months follow-up. Pre-operatively, patients were examined under standardized conditions. Postoperatively we analyzed the following: standardized interview and examination as well as pelvic floor ultrasound: 2D with a transvaginal probe and 4D with an abdominal probe. RESULTS:There was one case of intraoperative bladder damage noticed and repaired followed with NAZCA implantation. In 2 cases vaginal erosion was found that healed successfully after re-operation. In 3 cases hematomas were observed but resolved spontaneously. After the surgery there was a statistically significant improvement of prolapse in anterior (p < 0.0003) and in central (p < 0.001) compartment. Six women (33.3%) had no stress urinary incontinence symptoms during the control visit but we did not find a statistically significant improvement in SUI symptoms after the procedure. We recorded no case of hypomobile urethra after the surgery. The mesh covered > 50% of the urethral length in all of the patients. CONCLUSIONS:Mid-term results showed that implantation of NAZCA TC mesh allows to achieve statistically significant im-provement in reducing cystocele coexisting with enterocele in over 65% of patients. A complete cure from stress urinary incontinence was confirmed in 1/3 of patients. NAZCA-TC covered more than 50% of the urethral length, which can possibly have a negative influence on the effectiveness of the suburethral tape.

journal_name

Ginekol Pol

journal_title

Ginekologia polska

authors

Wlaźlak E,Kluz T,Wróbel A,Krzycka M,Surkont G

doi

10.5603/GP.a2017.0105

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

579-584

issue

eissn

0017-0011

issn

2543-6767

pii

VM/OJS/J/51746

journal_volume

pub_type

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The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously - results controlled with a pelvic floor ultrasound. A preliminary study.