ABSTRACT

Objective:

Stress urinary incontinence associated with pelvic organ prolapse is a frequent condition. The aim was to evaluate whether insertion of the anterior arms of transobturator four arms mesh under the mid-urethra can treat simultaneously the cystocele and incontinence without causing de novo urgency symptoms or voiding dysfunction.

Methods:

A comparative prospective study was conducted. The study group included patients treated for stress urinary incontinence and cystocele with the same mesh. The control group included all patients treated with a seperated suburethral sling for stress urinary incontinence. Evaluation included POP-Q for prolapse documentation and cough stress test with full bladder for stress urinary incontinence. All patients completed the PFDI-20 and PFIQ-7 forms for prolapse symptoms and the PISQ-12 form for sexual function before and after the operation.

Results:

Fifteen patients in the study group were compared with 25 in the control group. The success rate of stress urinary incontinence treatment at the six-month follow-up was 93% for the study group and 84% for the control group. No signs of de novo urgency symptoms or persistent voiding dysfunction were detected. Significant improvement in mean total score and urinary score was detected in both groups on both pelvic floor questionnaires, and there was no difference between the groups before and after the operation. Sexual function improved in both groups.

Conclusions:

Stress urinary incontinence accompanied by cystocele can be treated in one operation with the same transobturator mesh, achieving both anatomical and functional cure and improvement in the patient’s quality of life.