Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study

Abstract Objective To compare the functional (obstruction relieving) outcomes and complications of unilateral J‐cut division, partial and subtotal vaginal removal techniques were performed for mesh‐related urethral obstruction (MRUO) in females. Methods Patient review included demographics, a medica...

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Main Authors: Bülent Çetinel, Göktuğ Kalender, Elif Altınay Kırlı, Aydın Yenilmez, Ömer Gülpınar, Adnan Şimşir, Gökhan Temeltaş, Alkan Çubuk, Günay Can
Format: Article
Language:English
Published: Wiley 2024-06-01
Series:BJUI Compass
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Online Access:https://doi.org/10.1002/bco2.350
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author Bülent Çetinel
Göktuğ Kalender
Elif Altınay Kırlı
Aydın Yenilmez
Ömer Gülpınar
Adnan Şimşir
Gökhan Temeltaş
Alkan Çubuk
Günay Can
author_facet Bülent Çetinel
Göktuğ Kalender
Elif Altınay Kırlı
Aydın Yenilmez
Ömer Gülpınar
Adnan Şimşir
Gökhan Temeltaş
Alkan Çubuk
Günay Can
author_sort Bülent Çetinel
collection DOAJ
description Abstract Objective To compare the functional (obstruction relieving) outcomes and complications of unilateral J‐cut division, partial and subtotal vaginal removal techniques were performed for mesh‐related urethral obstruction (MRUO) in females. Methods Patient review included demographics, a medical history and proforma with details of lower urinary tract symptoms (LUTS), physical and urodynamic findings, detailed surgical reports and follow‐up data. Variables were compared between the three groups. Results Out of 130 patients with sling revision surgery (SRS), 54 women underwent SRS for MRUO with a median follow‐up of 48 (17–96) months. Unilateral J‐cut division, partial and subtotal vaginal removal techniques were performed in 12, 31 and 11 patients with a median duration of surgery of 30 (25–34), 40 (35–56) and 60 (60–70) minutes, respectively (p = 0.001). Statistically significant increase in median maximum free urine flow rate and decrease in median post‐void residual urine volume were found after SRS in the three groups, while de novo stress urinary incontinence (SUI) developed in 10%, 44% and 60% of the patients in the unilateral J‐cut division, partial and subtotal removal groups, respectively (p = 0.007). Conclusions The unilateral J‐cut division technique was as effective as the partial and subtotal vaginal removal techniques in relieving MRUO with a shorter duration of surgery time (p = 0.001) and lower risk of de novo SUI (p = 0.007). Comparative studies with a larger number of patients are needed.
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spelling doaj-art-45e1b4158b2e4fcca9f1a1db1a2e35e12024-12-23T09:56:20ZengWileyBJUI Compass2688-45262024-06-015666567110.1002/bco2.350Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative studyBülent Çetinel0Göktuğ Kalender1Elif Altınay Kırlı2Aydın Yenilmez3Ömer Gülpınar4Adnan Şimşir5Gökhan Temeltaş6Alkan Çubuk7Günay Can8Cerrahpaşa Faculty of Medicine, Department of Urology Istanbul University‐Cerrahpaşa Istanbul TurkeyCerrahpaşa Faculty of Medicine, Department of Urology Istanbul University‐Cerrahpaşa Istanbul TurkeyCerrahpaşa Faculty of Medicine, Department of Urology Istanbul University‐Cerrahpaşa Istanbul TurkeyFaculty of Medicine, Department of Urology Eskişehir Osmangazi University Eskişehir TurkeyFaculty of Medicine, Department of Urology Ankara University Ankara TurkeyFaculty of Medicine, Department of Urology Ege University Bornova TurkeyFaculty of Medicine, Department of Urology Celal Bayar University Manisa TurkeyFaculty of Medicine, Department of Urology Kırklareli University Kırklareli TurkeyCerrahpaşa Faculty of Medicine, Department of Public Health Istanbul University‐Cerrahpaşa Istanbul TurkeyAbstract Objective To compare the functional (obstruction relieving) outcomes and complications of unilateral J‐cut division, partial and subtotal vaginal removal techniques were performed for mesh‐related urethral obstruction (MRUO) in females. Methods Patient review included demographics, a medical history and proforma with details of lower urinary tract symptoms (LUTS), physical and urodynamic findings, detailed surgical reports and follow‐up data. Variables were compared between the three groups. Results Out of 130 patients with sling revision surgery (SRS), 54 women underwent SRS for MRUO with a median follow‐up of 48 (17–96) months. Unilateral J‐cut division, partial and subtotal vaginal removal techniques were performed in 12, 31 and 11 patients with a median duration of surgery of 30 (25–34), 40 (35–56) and 60 (60–70) minutes, respectively (p = 0.001). Statistically significant increase in median maximum free urine flow rate and decrease in median post‐void residual urine volume were found after SRS in the three groups, while de novo stress urinary incontinence (SUI) developed in 10%, 44% and 60% of the patients in the unilateral J‐cut division, partial and subtotal removal groups, respectively (p = 0.007). Conclusions The unilateral J‐cut division technique was as effective as the partial and subtotal vaginal removal techniques in relieving MRUO with a shorter duration of surgery time (p = 0.001) and lower risk of de novo SUI (p = 0.007). Comparative studies with a larger number of patients are needed.https://doi.org/10.1002/bco2.350bladder outlet obstructionde‐novo stress urinary incontinencemesh‐related obstructionsling excisionsling incisionsurgical outcomes
spellingShingle Bülent Çetinel
Göktuğ Kalender
Elif Altınay Kırlı
Aydın Yenilmez
Ömer Gülpınar
Adnan Şimşir
Gökhan Temeltaş
Alkan Çubuk
Günay Can
Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study
BJUI Compass
bladder outlet obstruction
de‐novo stress urinary incontinence
mesh‐related obstruction
sling excision
sling incision
surgical outcomes
title Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study
title_full Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study
title_fullStr Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study
title_full_unstemmed Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study
title_short Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study
title_sort unilateral j cut division versus partial and subtotal removal techniques in female patients with mesh related urethral obstruction multicentric comparative study
topic bladder outlet obstruction
de‐novo stress urinary incontinence
mesh‐related obstruction
sling excision
sling incision
surgical outcomes
url https://doi.org/10.1002/bco2.350
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