Background: Mixed urinary incontinence (MUI) has always represented a major therapeutic challenge and the management of this type of incontinence is often complicated by uncertain outcomes. Surgical options include interventions targeting both stress urinary incontinence (SUI) and urge urinary incontinence (UUI), although there are no international published guidelines that dictate whether it is better to start with surgical management to address the SUI or UUI component after the failure of conservative treatment. The aim of the present study is to evaluate the effectiveness of the Macroplastique (MPQ) procedure on overactive bladder (OAB) symptoms in women with MUI with a minimum follow-up of 1 year. Methods: A retrospective analysis of prospectively collected data was performed in two tertiary reference centers. We enrolled all women complaining of symptoms of SUI and OAB, dry or wet, with a urodynamically confirmed diagnosis of MUI [urodynamic stress incontinence (USI) with detrusor overactivity (DO)], who took a previous ineffective antimuscarinic treatment and underwent the MPQ procedure. We considered as objectively cured women who did not leak urine during the stress test and with a 1 h pad-test negative, while International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), ICIQ-OAB, Patient Global Impression of Improvement (PGI-I) scale, and a Visual Analogue Scale (VAS) were used to assess subjective outcomes. Results: A total of forty-six patients who met the inclusion criteria and who underwent the MPQ procedure were considered for the analysis. At the 1-year mark of follow-up, 72% of patients were objectively cured at stress test and 65% were objectively cured at pad-test, while 72% of women declared themselves subjectively cured. OAB symptoms significantly improved after MPQ and a complete resolution of OAB was recorded in 35% of patients. Conclusions: This study demonstrated that MPQ is a safe and effective option for the treatment of female MUI. Furthermore, MPQ significantly improves the symptoms of OAB and is able to completely cure this condition in a relevant percentage of women with MUI when pharmacological treatment fails.
Journal of clinical medicine. 2024 Sep 28*** epublish ***
Maurizio Serati, Maria Rosaria Campitiello, Marco Torella, Giada Mesiano, Chiara Scancarello, Fabio Ghezzi, Andrea Papadia, Elena Gamarra, Giorgio Caccia, Andrea Braga
Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, 21100 Varese, Italy., Department of Obstetrics and Gynecology and Physiopathology of Human Reproduction, ASL Salerno, 84131 Salerno, Italy., Department of Gyanecology, Obstetric and Reproductive Science, Second University of Naples, 80138 Naples, Italy., Department of Obstetrics and Gynecology, Ente Ospedaliero Cantonale-Civico Hospital, 6900 Lugano, Switzerland., Department of Endocrinology and Diabetology, EOC-Civico Hospital, 6900 Lugano, Switzerland., Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, 6850 Mendrisio, Switzerland., Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland.