Unilateral J-cut division versus partial and subtotal removal techniques in female patients with mesh-related urethral obstruction: Multicentric comparative study

Cetinel B., KALENDER G., KIRLI E. A., YENİLMEZ A., GÜLPINAR Ö., ŞİMŞİR A., ...Daha Fazla

BJUI COMPASS, cilt.5, sa.6, ss.551-557, 2024 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 5 Sayı: 6
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1002/bco2.350
  • Dergi Adı: BJUI COMPASS
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Sayfa Sayıları: ss.551-557
  • Anahtar Kelimeler: bladder outlet obstruction, de-novo stress urinary incontinence, mesh-related obstruction, sling excision, sling incision, surgical outcomes, voiding dysfunction
  • Ankara Üniversitesi Adresli: Evet

Özet

ObjectiveTo compare the functional (obstruction relieving) outcomes and complications of unilateral J-cut division, partial and subtotal vaginal removal techniques were performed for mesh-related urethral obstruction (MRUO) in females.MethodsPatient review included demographics, a medical history and proforma with details of lower urinary tract symptoms (LUTS), physical and urodynamic findings, detailed surgical reports and follow-up data. Variables were compared between the three groups.ResultsOut of 130 patients with sling revision surgery (SRS), 54 women underwent SRS for MRUO with a median follow-up of 48 (17-96) months. Unilateral J-cut division, partial and subtotal vaginal removal techniques were performed in 12, 31 and 11 patients with a median duration of surgery of 30 (25-34), 40 (35-56) and 60 (60-70) minutes, respectively (p = 0.001). Statistically significant increase in median maximum free urine flow rate and decrease in median post-void residual urine volume were found after SRS in the three groups, while de novo stress urinary incontinence (SUI) developed in 10%, 44% and 60% of the patients in the unilateral J-cut division, partial and subtotal removal groups, respectively (p = 0.007).ConclusionsThe unilateral J-cut division technique was as effective as the partial and subtotal vaginal removal techniques in relieving MRUO with a shorter duration of surgery time (p = 0.001) and lower risk of de novo SUI (p = 0.007). Comparative studies with a larger number of patients are needed.