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. 2024 Mar 25;5(6):551-557.
doi: 10.1002/bco2.350. eCollection 2024 Jun.

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

Bülent Çetinel  1 , Göktuğ Kalender  1 , Elif Altınay Kırlı  1 , Aydın Yenilmez  2 , Ömer Gülpınar  3 , Adnan Şimşir  4 , Gökhan Temeltaş  5 , Alkan Çubuk  6 , Günay Can  7
Affiliations

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

Bülent Çetinel et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

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.

Keywords: bladder outlet obstruction; de‐novo stress urinary incontinence; mesh‐related obstruction; sling excision; sling incision; surgical outcomes; voiding dysfunction.

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Conflict of interest statement

There is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A) Sling‐related obstruction, (B) unilateral sling division, (C) unilateral ‘J‐cut’ sling division, (D) midline sling dissection and division, (E) partial vaginal removal, (F) unilateral sling dissection and division, (G) peeling the sling from underneath the urethra towards the contralateral ischiopubic ramus, (H) subtotal vaginal removal.
FIGURE 2
FIGURE 2
Flow chart of inclusion and exclusion criteria.
See this image and copyright information in PMC

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