Mesh Cutting after Midurethral Sling Procedure in Female Stress Urinary Incontinence: 1 Year Follow-up.

Purpose: Midurethral sling procedure is widely used as a primary choice for managing female stress urinary incontinence (SUI) in many countries. But some complications are inevitable, although the incidence is very low. Mesh cutting may be required to correct unwanted problems in some patients. We evaluated the outcome of mesh cutting in patients having mesh-related complications. Materials and Methods: Medical records of patients who underwent cutting of midurethral tape from January 2001 to December 2005 were reviewed and a detailed telephone interview was done to see if stress urinary incontinence recurred at least a year after cutting. Results: Eleven patients were included in this study. Mean age was 51.2 ranging from 41 to 70. The reasons why their meshes should be cut were as follows; eight (72.7%) had voiding difficulty, two (18.2%) had a tape erosion and one had voiding difficulty and overactive bladder. These problems were corrected by mesh cutting except one. However, a year after cutting, four out of eleven patients (36.4%) developed recurrent stress urinary incontinence. Recurrence occurred in three out of five patients (60.0%) whose meshes were cut within 1 month after implant, while occurred in 1 out of 6 (16.7%) whose meshes were cut after 2 months of implant. Three out of four patients (75.0%) who had mixed urinary incontinence developed recurrence after mesh cutting. In particular, two patients who had detrusor overactivity confirmed by cystometry before surgery showed recurrence of incontinence after mesh cutting. Conclusion: A total 36.4% of patients who required mesh cutting developed recurrence of SUI. These data demonstrate that mesh cutting may cause recurrence and urologists should be aware that mesh cutting may be disappointing. Mixed urinary incontinence and duration from implant to mesh cutting seem to be the risk factors of recurrence after mesh cutting. (J. Korean Continence Society 2007;11:59-62)