Surgical Treatment of Stress Urinary Incontinence Using a Simple Operative Procedure of Meshplasty

Abstract

OBJECTIVEAim is to establish/evaluate the simplicity, effectiveness and safety of mesh plasty using polypropylene mesh in stress urinary incontinence. The treatment of stress urinary incontinence has undergone a revolution in recent years due to emergence on the market of suburethral slings. METHODThe present study was conducted on 52 patients who came in OPD of Department of Obstetrics and Gynaecology, SMGS Hospital, Govt. Medical College, Jammu, over the period of three years (Jan 2012 to Dec 2014) with clinical evidence of stress urinary incontinence with or without various degrees of genital prolapse or DUB. Patients were evaluated preoperatively by taking history, detailed general and systemic examination. Various clinical investigations were also done. A polypropylene mesh was placed at mid urethral level. Simultaneous repair of pelvic floor defect and/or vaginal hysterectomy was performed in the same sitting. Postoperative follow-up included physical examination and also assessing patient's satisfaction level. RESULTSNo major complication occurred in intraoperative/postoperative period except for mesh erosion in one patient. CONCLUSIONMeshplasty is relatively safe, simple, quick and cost effective surgical treatment for stress urinary incontinence. KEYWORDSStress Urinary Incontinence, Meshplasty, Propylene Mesh. HOW TO CITE THIS ARTICLE: INTRODUCTIONIn normal urinary bladder the pressure in U. bladder does not increase with filling of urine, it is due to centrally mediated neuronal reflexes. The bladder outlet and urethra are closed at rest to maintain continence. During bladder emptying, there is decrease in urethral resistance followed by voluntary contraction of the bladder. The relaxation of urinary sphincter and pelvic floor muscles permit urine to flow into urethra. With rare exception the urinary incontinence occurs when pressure in urinary bladder increases than urethral resistance and urine flows involuntarily beyond urinary sphincter. Alteration in anatomy or function of bladder or urethra during storage/filling or emptying phases of urination may lead to urinary incontinence. Urinary incontinence due to poorly functioning urethra is called SUI. (1)