SHORT TERM OUTCOMES OF SURGEON TAILORED PROLENE MESH (STPM) AS TRANSOBTURATOR TAPE (TOT) FOR TREATMENT OF FEMALE STRESS URINARY INCONTINENCE Ashraf Nassif Mahmoud Elmantwe and Tamer Mahmoud Assar Lecturers of Obstetrics and Gynecology Department, Benha University Hospital, Benha University Egypt
Objective: The aim of this trial is to describe the use of surgeon tailored ordinary prolene mesh (STPM) and available resterlizable helical or S shaped passers to do transobturator tape (TOT) as a low cost alternative to available commercial kits (CK) in treatment of stress urinary incontinence (SUI ) in female with evaluation of its safety and short term efficacy. Patient and methods: STPM tape (15 x 1.5 cm) was inserted as outside-in TOT in 35 women (data of 30 of them were available for analysis, as 5 were lost in follow up ) with pure SUI 23/30 (76.7%) and 7/30 (23.3) with mixed incontinence but predominant element was SUI, at Benha University Hospital, obstetrics and gynecology department between May 2013 to May 2014, SUI was diagnosed by positive cough stress test (CST). Women with post void residual urine (PVRU) >100 ml, bladder capacity <300ml, evident urge incontinence or neurological lesion were excluded statistically analysis by medcalc easy-to- use software for window desktop was done. Results: the mean age was 42±7.5 years, STPM outside in TOT rocedure done alone in 22/30 (73%) and with other prolapse procedures in 8/30 (26%). No major complications, lower urinary tract injuries or mesh erosion were reported. Improvement of SUI symptom score postoperatively was significantly (p<0.0001), urinary symptoms impact on quality of life (QOL) was significantly (P<0.0001) improved after STPM insertion also the visual analogue scale urinary incontinence severity was also significantly (P<0.0001) improved postoperatively, but the Q-MAX were significantly (P<0.0001) reduce by STPM insertion Conclusion: surgeon tailored prolene mesh insertion as outside-in trans obturator procedure was easy, safe, effective treatment for women with stress urinary incontinence.