E-Posters-Native Tissue Mid-Urethral Support: A Retrospective Review of a Novel Approach to Prevent and Treat Stress Urinary Incontinence Associated with Pelvic Organ Prolapse Vaginal Surgery

Native Tissue Mid-Urethral Support: A Retrospective Review of a Novel Approach to Prevent and Treat Stress Urinary Incontinence Associated with Pelvic Organ Prolapse Vaginal Surgery - Lai-Yet Lam, MD

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This document discusses the use of a novel approach called Native Tissue Mid-Urethral Support (NTMU) for the prevention and treatment of stress urinary incontinence (SUI) in patients undergoing pelvic organ prolapse (POP) vaginal surgery. The traditional use of mesh slings or tape has become standard for SUI treatment, but concerns of mesh rejection have led some patients to refuse mesh placement. The study enrolled 56 women who declined mesh and underwent NTMU instead. 82% of the women reported that urine leakage did not bother them after surgery. Among those with pre-operative urinary incontinence, 89% reported improvement, and 67% reported improvement among those with pre-operative stress urinary incontinence (SUI). However, 14% of patients without SUI before surgery reported SUI after the procedure. There were no intraoperative complications, but 23% of patients experienced urinary retention requiring an indwelling catheter for up to 3 weeks. All patients were able to void normally after being instructed to perform clean intermittent catheterization, and there were no other post-operative complications. The authors concluded that NTMU has similar efficacy to mesh slings for preventing urinary incontinence in patients undergoing POP surgery, without the associated morbidity, mortality, rejection of foreign material, and costs of mesh slings. The study found a 26% reduction in urinary incontinence after NTMU, particularly among patients aged 45 to 69. The authors recommend NTMU as an alternative to mesh slings for SUI treatment.

Keywords

Native Tissue Mid-Urethral Support

stress urinary incontinence

pelvic organ prolapse

vaginal surgery

mesh slings

urine leakage

urinary retention

catheterization

efficacy

SUI treatment