Long-term results of the use of suburethral loop plastic surgery with tension control in the treatment of urinary incontinence.

Introduction. Urinary incontinence is a disease that significantly reduces the quality of life in patients. Suburethral loop plasty is still the gold standard for the treatment of stress urinary incontinence, which is highly effective, but also has a number of possible postoperative complications. The purpose of this article is to evaluate the long-term results (after 4 years), the effectiveness and safety of the use of suburethral loop plasty with tension control. Materials and methods. Currently, there is no single way to adjust the tension of the hinge during its installation. At the Department of Urology of A.I. Yevdokimov Moscow State University of Medicine and Dentistry developed a device to control the tension of the loop, presented in the form of a self-absorbable pad (damper layer) located in the middle of a synthetic prosthesis. A prospective, comparative, randomized study that began in 2018 showed a high efficacy and safety profile for this device. When analyzing the results 1 year after the operation, the effectiveness of surgical treatment was 96%, the rate of postoperative complications in the form of infravesical obstruction was 2%, de novo urgency in the study group was 6%. In this study, we assessed long-term mid-term outcomes (over 4 years) through a telephone survey and filling in validated questionnaires (Urogenital distress inventory – UDI-6, Incontinence Impact Questionnaire – IIQ-7) among patients who underwent suburethral loop plasty with a loop tension control device. Results. The average score on the UDI-6 survey was 1.22 ±0.81, and 1.2±0.77 on the IIQ-7 survey. After a telephone survey after 48 months, there was a slight increase in scores, when compared with the results of the survey 12 months after surgical treatment, but not statistically significant (p>0.05). In the analysis of individual clinical cases after 48 months, 10 patients noted worsening of symptoms. Of these, 6 patients noted a recurrence of urinary incontinence when coughing, physical activity. Accordingly, the subjective effectiveness of surgical treatment over a 4-year follow-up period was 88%. Conclusions. Efficacy and safety data, in the medium-term follow-up of patients after suburethral loop plasty with tension control, are comparable to world data. However, further monitoring of patients in the long term is required.