Risk Factors and Countermeasures of Stress Urinary Incontinence after Mesh Implantation for Patients with Pelvic Organ Prolapse
Archivos Españoles de Urología(2023)
摘要
Objectives: We aimed to explore the risk factors and countermeasures of stress urinary incontinence (SUI) after mesh implantation for patients with pelvic organ prolapse (POP).Methods: A total of 224 POP patients undergoing mesh implantation from January 2018 to December 2021 were divided into group A (n = 68, postoperative new-onset SUI) and group B (n = 156, without postoperative new-onset SUI). Their clinical data were collected, and the treatment outcomes were analyzed. The independent risk factors for postoperative new-onset SUI were determined through multivariate logistic regression analysis. A risk-scoring model was established and assessed. The patients with postoperative new-onset SUI were divided into low-, moderate- and high-risk groups using this model.Results: Mesh implantation significantly improved the pelvic floor muscle strength and function of patients. Multivariate logistic regression analysis revealed that age & GE;50 years old, gravidity & GE;3 times, parity & GE;3 times, history of macrosomia delivery, history of chronic respiratory diseases, vaginal delivery, and perineal laceration were independent risk factors for postoperative new-onset SUI, and pelvic floor muscle training by biofeedback electrical stimulation was a protective factor (p < 0.05). The risk-scoring model was safe, reliable and practical, with high discrimination, accuracy and efficiency.Conclusions: Age & GE;50 years old, gravidity & GE;3 times, parity & GE;3 times, history of macrosomia delivery, history of chronic respiratory diseases, vaginal delivery, and perineal laceration are independent risk factors for postoperative new-onset SUI, and pelvic floor muscle training by biofeedback electrical stimulation is a protective factor. Therefore, POP patients with new-onset SUI following mesh implantation should receive more pelvic floor muscle training.
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关键词
pelvic organ prolapse,mesh implantation,stress urinary incontinence,risk factor,countermeasure
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