Comparison of the efficiency of partial versus subtotal mesh removal on urogenital distress and sexual functions after stress urinary incontinence surgery

Özet

Objective: To compare the efficiency of the partial mesh removal (PMR) versus subtotal mesh removal (SMR) on urogenital distress and sexual functions in patients who experienced vaginal mesh extrusion.Material and methods: Between June 2014 and January 2018, 45 patients who experienced vaginal mesh extrusion following midurethral sling surgeries and therefore underwent mesh excision were evaluated ret-rospectively. The effectiveness of PMR and SMR was compared using the “Urinary Distress Inventory-6 (UDI-6)” and “Female Sexual Function Index (FSFI)” forms, at the 6th month postoperatively.Results: Fourteen PMR-patients and 21 SMR-patients who met the study criteria were evaluated for the study. There was a significant improvement in UDI-6 scores and FSFI scores in both PMR and SMR groups at the 6th month postoperatively (p=0.001, p=0.001, p=0.001, and p=0.001, respectively). When the two groups were compared in terms of improvement rates, there was no significant difference in UDI-6 scores [(−)30.21±6.56% vs. (−)26.33±9.01%, p=0.222]. However, there was a statistically significant improvement in the FSFI scores in the SMR group [(+)83.71±14.81% vs. (+)124.42±36.82%, p=0.001]. There was no sig-nificant difference in overactive bladder symptoms between the two groups, with a decrease of 75% in the PMR group and 71.42% in the SMR group (p=0.721). Recurrent stress urinary incontinence was observed in two (14.2%) patients in the PMR group and four (19.1%) patients in the SMR group at the 6th month postoperatively (p=0.544).Conclusion: In cases where extrusion is developed, subtotal/total mesh removal provides a significant im-provement in patients’ complaints of sexual dysfunction related to extrusion.