A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes

“… 10 Moreover, recent studies have shown that a low MUCP was associated with a failure of surgery for SUI in women. 11 , 12 The results of our study revealed that the AUL was observed to positively correlate with the MUCP.…”

Section: Discussionsupporting

confidence: 50%

Clinical significance of anatomical urethral length on stress urinary incontinence women

Shin

You

et al. 2018

IJWH

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ObjectiveTo evaluate the association between the length of the female urethra and urodynamic study (UDS) parameters in patients presenting with stress urinary incontinence (SUI).Patients and methodsWe retrospectively enrolled 391 women who underwent a transobturator adjustable tape sling implantation for the management of SUI between April 2009 and March 2016. All patients underwent a physical examination and UDS. Filling cystometry data that were evaluated included the Valsalva leak point pressure, and the cough leak point pressure. The maximal urethral closure pressure, the functional urethral length (FUL), and the length of the continence zone (LCZ) were measured using the urethral profile obtained from the UDS. The anatomical urethral length (AUL) was measured intraoperatively using a Foley catheter. We calculated the LCZ/FUL ratio to determine the anatomical continence length for this study.ResultsWe noted that 299 patients completed the study. The mean AUL was 26.25±3.59 mm. The mean FUL and LCZ were 41.37±15.05 mm and 24.15±13.90 mm, respectively. The mean LCZ/FUL was 0.57±0.19. Using the Pearson correlation coefficient, we observed that the AUL showed a correlation with the FUL (0.168, P=0.034), the LCZ (0.212, P=0.007), the LCZ/FUL ratio (0.190, P=0.016), the Valsalva leak point pressure (0.223, P=0.005), the cough leak point pressure (0.215, P=0.006), and the maximal urethral closure pressure (0.178, P=0.043).ConclusionOur results show that the AUL in women is associated with UDS parameters relating to SUI.

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“…It also showed that after the mini-sling surgery, the patients experience less pain in comparison to TOT; also 1 year after surgery, the maximal urethral closure pressure (MUCP) and mean Qmax showed a greater decline in the TOT group compared to the mini-sling group. 12 In a study by Wu et al 13 from 2005 to 2014 in Taiwan on 122 women with stress urinary incontinence, the two methods of TOT and mini-sling showed similar results regarding surgical outcomes and urodynamic indices except for a longer surgical time and hospitalization period, more bleeding, and a higher risk of incontinence in the TOT group. Given urinary incontinence which was not reported in 80 patients of the mentioned study, the findings were consistent with our results from other aspects.…”

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Transobturator tape and mini-sling methods in stress urinary incontinence: Results of a randomized clinical trial

et al. 2019

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Background: Stress urinary incontinence is one of the most common types of incontinence in premenopausal women, accounting for almost 50% of such cases. Mid-urethral slings are currently the most widely used surgical method for stress urinary incontinence. This study aimed at comparing the efficacy, complications, urodynamic changes and the sexual function status between mini-sling surgery and transobturator tape to help us select the best method in such patients. Method: In this randomized controlled trial, 80 cases were studied and randomly assigned to either the mini-sling or transobturator tape group (n = 40). A full medical history was taken and the Q.tip and cough tests were performed for each patient to record their urinary incontinence and hypermobility. Abdominal and pelvic ultrasound study was requested by specifying PVR and urodynamic testing. The International Consultation on Incontinence Modular Questionnaire-6 was filled by the patients and the Female Sexual Functioning Index questionnaire by the physician. The patients were followed-up 8 weeks after discharge by urodynamic tests, ultrasound study, and the International Consultation on Incontinence Modular Questionnaire test. Results: The mean age, body mass index, and parity were not significantly different between the two groups. The mean surgical time, amount of bleeding, hospitalization period, and pain index were significantly less in the mini-sling group. The International Consultation on Incontinence Modular Questionnaire and Female Sexual Functioning Index indices before and after surgery showed no significant difference between the two groups. The difference in urodynamic test parameters was also insignificant. Conclusion: In the mini-sling method which is a less invasive method compared to transobturator tape, the intraoperative bleeding, surgical time, hospitalization period, pain, and surgical complications were far less while its efficacy was similar to transobturator tape; therefore, it is recommended in treating stress urinary incontinence among women.

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A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes

Cited by 12 publications

References 25 publications

A Randomized Comparison of a Single-incision Midurethral Sling and a Transobturator Midurethral Sling in Women with Stress Urinary Incontinence: Results of 12-mo Follow-up

A Randomized Comparison of a Single-incision Midurethral Sling and a Transobturator Midurethral Sling in Women with Stress Urinary Incontinence: Results of 12-mo Follow-up

Clinical significance of anatomical urethral length on stress urinary incontinence women

Transobturator tape and mini-sling methods in stress urinary incontinence: Results of a randomized clinical trial

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