Our experience of surgical treatment of recurrent urinary incontinence in women after the installation of a synthetic implant

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Abstract

BACKGROUND: The article presents data on the frequency of recurrence of urinary incontinence in women after the installation of a synthetic implant, as well as methods for the surgical elimination of this pathology. The described urogynecological problem is relevant and widespread.

MATERIALS AND METHODS: The results of surgical treatment of 16 women with pelvic organ prolapse and recurrent urinary incontinence after sling operations are presented. All patients underwent laparoscopic colpovesicosuspension.

RESULTS: In the postoperative period positive dynamics was noted during the examination using the POP-Q system and the results of the questionnaire using the ICIQ-SF questionnaire, which was observed throughout the follow-up period of 12 months. Complications in the immediate and long-term postoperative period were not identified. For the entire period of observation of the patients, recurrence of prolapse was not observed in any case.

CONCLUSION: The proposed method of surgical treatment of recurrence of urinary incontinence in women with mesh implants is effective and safe.

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About the authors

Suleyman I. Suleymanov

People’s Friendship University of Russia; City Clinical Hospital No. 13 of the Moscow Healthcare Department

Author for correspondence.
Email: s.i.suleymanov@mail.ru
ORCID iD: 0000-0002-0461-9885
SPIN-code: 7168-8819
Scopus Author ID: 57080003900

Dr. Sci. (Med.), Professor of the Department of Endoscopic Urology, Faculty of Continuous Medical Education, Institute of Medicine; Head of the Urology Department

Russian Federation, Moscow; Moscow

Dmitriy A. Pavlov

People’s Friendship University of Russia

Email: dpavlov.doc@gmail.com

Cand. Sci. (Med.), Doctoral Candidate, Department of Endoscopic Urology, Faculty of Continuous Medical Education, Institute of Medicine

Russian Federation, Moscow

Sergey E. Arakelov

People’s Friendship University of Russia; City Clinical Hospital No. 13 of the Moscow Healthcare Department

Email: gkb13@gkb13.ru
ORCID iD: 0000-0003-3911-8543
SPIN-code: 4970-8419

Dr. Sci. (Med.), Professor, Head of the Department of Family Medicine with a Course in Palliative Care, Chief Physician

Russian Federation, Moscow; Moscow

Alexey V. Baranov

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: aleksey-baranov@mail.ru
ORCID iD: 0000-0002-7995-758X

Dr. Sci. (Med.), Professor of the Department of Surgery and Surgical Technologies

Russian Federation, Moscow

Alexander S. Babkin

City Clinical Hospital No. 13 of the Moscow Healthcare Department

Email: alexbabkin3004@mail.ru
ORCID iD: 0000-0003-1570-1793

Urologist

Russian Federation, Moscow

References

  1. Suleymanov SI, Pavlov DA, Arakelov SE, et al. Principles of surgical treatment of mixed urinary incontinence in women. Gynecology, Obstetrics and Perinatology. 2022;21(1):59–66. (In Russ.) doi: 10.20953/1726-1678-2022-1-59-66
  2. Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary incontinence in women: a review. JAMA. 2017;318(16):1592–1604. doi: 10.1001/jama.2017.12137
  3. Abrams P, Cardozo L, Wein A. 3rd International Consultation on Incontinence — Research Society 2011. Neurourol Urodyn. 2012;31(3):291–292. doi: 10.1002/nau.22221
  4. Silaeva EA, Timoshkova YL, Atayants KM, et al. Epidemiology and risk factors for pelvic organ prolapse. Russian Military Medical Academy Reports. 2020;39(S3–1):161–163. (In Russ.)
  5. Ishchenko AI, Ishchenko AA, Khokhlova ID, et al. Promontofixation using titanium implant in patients with polyvalent allergy and combined gynecologic pathology. Gynecology, Obstetrics and Perinatology. 2021;20(4):170–173. (In Russ.) doi: 10.20953/1726-1678-2021-4-170-173
  6. Glazener CM, Cooper K, Mashayekhi A. Bladder neck needle suspension for urinary incontinence in women. Cochrane Database Syst Rev. 2017;7(7): CD003636. doi: 10.1002/14651858.CD003636.pub4
  7. Nechiporenko AN, Mihal’chuk ECh, Nechiporenko EA. Surgical correction of pelvic organ prolapse: rationale for the use of synthetic implants. Experimental and clinical urology. 2020;(1):130–135. (In Russ.) doi: 10.29188/2222-8543-2020-12-1-130-135
  8. Ishchenko AI, Aleksandrov LS, Ishchenko AA, et al. Mesh-ligature correction of posterior vaginal wall prolapse grade II–III using titanium mesh implants. Gynecology, Obstetrics and Perinatology. 2020;19(3):14–21. (In Russ.) doi: 10.20953/1726-1678-2020-3-14-21
  9. Capobianco G, Madonia M, Morelli S, et al. Management of female stress urinary incontinence: A care pathway and update. Maturitas. 2018;109:32–38. doi: 10.1016/j.maturitas.2017.12.008
  10. Snurnitsyna O, Glybochko P, Rapoport L, et al. Transvaginal repair of anterior and apical prolapse using OPUR6-strap mesh: five years of experience. J Urol. 2019;201(S-4):e14–e14. doi: 10.1097/01.JU.0000554922.25560.40
  11. Zhumanova EN, Koneva ES, Shapovalenko TV, et al. Non-drug technologies in comprehensive treatment of urinary incontinence in women. Physiotherapist. 2020;(1):64–77. (In Russ.) doi: 10.33920/med-14-2002-11
  12. Ford AA, Rogerson L, Cody JD, et al. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2017;7(7): CD006375. doi: 10.1002/14651858.CD006375.pub4
  13. Loran OB, Seregin AV, Dovlatov ZA. Usage of POP-Q system in assessment of state of patients before and after corrections of pelvic prolapse. Journal of Siberian Medical Sciences. 2015;(5):27. (In Russ.)
  14. Patent RUS № 2721140/18.05.2020 г. Byul. № 14. Pavlov DA, Toporova VN. Sposob operativnogo lecheniya nederzhaniya mochi u zhenshchin. (In Russ.)

Supplementary files

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2. Fig. 1. Videoendoscopic colpovesicosuspension. The stage of opening the parietal peritoneum: the anterior wall of the abdomen (1); the parietal sheet of the peritoneum (2)

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3. Fig. 2. Videoendoscopic colpovesicosuspension. Visualization of the prevesical space: symphysis of the womb (1); urinary bladder (2)

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4. Fig. 3. Videoendoscopic colpovesicosuspension. Visualization of the surgical field: symphysis (1); Cooper’s ligaments (2); Gimbert’s ligaments (3); urinary bladder (4); tendon arches of the pelvis (5); vaginal walls (6)

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5. Fig. 4. Videoendoscopic colpovesicosuspension. Stage of ligation formation on the left: vaginal wall (1); urinary bladder (2)

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6. Fig. 5. Videoendoscopic colpovesicosuspension. Formed suspension mechanism (colposuspension): ligatures between the Cooper’s ligaments and the anterior-lateral wall of the vagina (1); urinary bladder (2)

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7. Fig. 6. Videoendoscopic colpovesicosuspension. Stage of the control revision. The arrows indicate: TVT mesh implant (1), suspending the device by stitching the side walls of the vagina (2) and the periosteum of the pubic bones (3)

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