The association between mesh-to-urethra distance and lower urinary tract symptoms in stress urinary incontinence patients surgically treated with an intra-operatively trimmed single incision mini-sling

Abstract

Objectives: We aimed to explore the association between mesh-to-urethra distance (MUD) and lower urinary tract symptoms (LUTS) in stress urinary incontinence (SUI) patients implanted with a single incision mini-sling (SIMS). Materials and Methods: This study included the patients who visited Urogynecology Outpatient Department of Muğla Sıtkı Koçman University Training and Research Hospital from November 2018 to November 2019 complaining of urinary incontinence and were diagnosed as having SUI. The patients were preoperatively questioned for their demographic characteristics, LUTS and any additional complaints. All patients underwent SIMS surgery with mesh trimmed during the operation. During the follow-ups carried out 48 hours, one month, and four months after the surgery, ultrasound to measure the distance from MUD was performed and patients were re-inquired about LUTS. Results: When MUD was postoperatively evaluated with regards to SUI, most successful outcomes were achieved when MUD was 2.69±1.25 mm (p<0.001), 2.68±1.30 mm (p<0.001) and 2.42±0.96 mm (p<0.001) at 48 hours, one month, and four months after the surgery, respectively. In terms of urination frequency, SUI surgery was successful when MUD was 2.93±1.36 mm (p=0.012) and 2.85±1.34 mm (p=0.001) at month one and month four, respectively. For nocturia, MUD was statistically significant at postoperative month four and nocturia of patients regressed when MUD was 2.78±1.21 mm (p=0.001). Conclusion: MUD seems to be a good predictor of treatment success in SUI treatment. There is a linear correlation between LUTS and MUD. To the present date, there is no study on association of LUTS and MUD in patients treated with mini slings