A Case Control Study to Establish the Efficacy of Mid Urethral Sling (Tot) Following Vaginal Prolapse Repair in Patients Without Urinary Incontinence

Introduction: Urinary incontinence is a disease caused by urinary bladder dysfunction or debilitated pelvic oor muscles and is prevalent among 30% of adult female. In recent years, transvaginal prolapse repair surgery is performed in a large number of cases and bladder neck suspensions have been largely replaced by mid urethral slings. This study is based on the hypothesis that if a midurethral sling is used as a support in the midurethral region at the time of prolapse surgery, it may contribute in reducing the risk of stress urinary incontinence in future. To establish Aim: the efcacy of midutheral sling in vaginal repair prolapse patients without urinary incontinence. Materials and Method: 240 women in the age group of 35 – 70 years presenting with anterior vaginal wall prolapse and no symptom of urinary incontinence were screened from the Department of Gynecology OPD of a tertiary care hospital. They were randomized in two arm- Active and Sham with 120 patients each post completion of consenting process. Urinary incontinence was reported by 0 vs 31.67% during 3 month follow up in act Results: ive and sham arm patients respectively. During the 1 year follow up also incontinence was more in sham arm patients (4.17% vs 39.17%). Adverse events like UTI, and bleeding were more in active arm but was statistically insignicant. Post void residual urine volume (ml) in active arm was more than that of sham (45.17±4.87 vs 39.41±6.71) during 3 month follow up but at the time of 1 year follow up sham arm reported higher post void residual urine volume (ml) than active arm (50.05±1.51 vs 55.79±1.51) It can to be concluded that use of mid urethral sl Conclusion: ing during vaginal prolapse surgery reduced case of stress induced urinary incontinence.