Objective: This study aims to long term follow-up evaluation of safety and efficacy of four arms polypropylene mesh in management of stress urinary incontinence (SUI) associated with cystocele.
Material and methods: The study was conducted on 50 female patients with stress urinary incontinence associated with cystocele. Patients subjected to transobturator four arms mesh. Evaluation of stress incontinence using cough stress test with and without prolapse reduction, Stamey’s grading of SUI, the validated Arabic version of the International Consultation on Incontinence Questionnaire-Short Form and king health questionnaire (KHQ). Collected perioperative parameters will include: Age, body mass index (BMI), grading of SUI, time of procedure, hospital stay after surgery, difference of serum hemoglobin before and after surgery, need for blood transfusion. Follow up will be at 3, 9 and 18 months after surgery.
Results: The mean operative time was 37.4±10.2 (25-60) minute. Blood transfusion was not required. The mean hospital stay was 30.5±10 (24-48) hrs. Five (10%) patients had fever and urinary tract infections were noticed in five (10%) patients. Two (4%) women had urine retention after catheter removal and vaginal mesh erosion presented in one (2%) patient. 40 (80%) patients were cured from SUI, 8 (16%) patients were improved and 2 (4%) patients failed.
Conclusion: Cystocele associated with SUI can be repaired with transobturator four arms mesh giving promising results with improved quality of life but with tolerable draw backs
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