Autologous transobturator midurethral sling

Cabuk, Alkan; Erbin, Akif; Savun, Metin; Ayrancı, Ali; Üçpınar, Burak; Yanaral, Fatih; Sarılar, Ömer; Başal, Şeref; Akbulut, Mehmet Akif

doi:10.5152/tud.2018.83797

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Therefore, a follow-up outcome of those treated is a future aspect of research. Transobturator approach autologous PVS had been described with favorable results, 24 , 25 based on previous study suggesting higher de novo urge incontinence rate in retropubic than transobturator MUS, 26 it is reasonable to hypothesize transobturator approach may decrease such rate. However, our cohort only underwent retropubic approach, more comparison study is needed in the future to validate if this phenomenon is true in autologous PVS.…”

Section: Discussionmentioning

confidence: 99%

Risk Factor of De Novo Urgency and Urge Incontinence After Autologous Fascia Pubovaginal Sling

Yang¹,

Delpe²,

Kowalik³

et al. 2021

RRU

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Introduction Pubovaginal sling is an efficient and safe procedure for stress urinary incontinence without the complications of synthetic sling. Urine retention and de novo urgency are bothersome aftermath of this procedure. We aim to identify potential risk factors for de novo urgency after autologous pubovaginal sling. Methods From 2013 to 2016, 347 patients underwent autologous pubovaginal sling. Age, BMI, pelvic irradiation, use of anticholinergic medication, previous vaginal related surgical histories, “over-tight” technique, and concomitant surgeries were examined for potential risk factors. De novo urgency/urge incontinence was defined as treatment (medication, botulinum toxin injection, sacral neuromodulation) for urge postoperatively and was not noted before surgery. Chi-square and fisher’s exact tests were used as statistical analysis. Results A total of 109 patients underwent autologous rectus fascia pubovaginal sling, after excluding status post urethral diverticulectomy, concomitant diverticulectomy, and concomitant abdominal surgery. Twenty-three (21.1%) patients were treated for de novo urge/urge incontinence, 18 (78.2%) with anticholinergic, 4 (17.3%) with botox injection and 2 (8.69%) with sacral neuromodulation. None but prior pelvic organ prolapse surgery was associated with developing de novo urge/urge incontinence (p=0.026). Discussion Patients with prior pelvic organ prolapse surgery were more likely to be at risk of de novo urgency after autologous pubovaginal sling. This study provided more information for preoperative consultation for patients undergoing incontinence surgery.

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Section: Discussionmentioning

confidence: 99%

Risk Factor of De Novo Urgency and Urge Incontinence After Autologous Fascia Pubovaginal Sling

Yang¹,

Delpe²,

Kowalik³

et al. 2021

RRU

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“…Additionally, a cystoscopy is performed during A-TOT if a bladder injury is suspected. In the final phase of the procedure, the incisions were closed by sutures, and vaginal packing was done [7].…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…In addition, new TVT and TOT techniques utilizing autologous tissues instead of synthetic meshes have been published. They reported a success rate of 79-94% and lower rates of complications compared to standard MUSS [6][7][8][9][10]. Some studies have compared new modifications to conventional slings.…”

Section: Introductionmentioning

confidence: 99%

Use of autologous fascia in midurethral sling surgeries; comparison of transobtrator and retropubic ways

Ozdemir,

Çolakoglu,

Topaloğlu

et al. 2023

Ginekol Pol

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Objectives: To compare autologous transobturator-tape (A-TOT) and autologous transvaginal tape (A-TVT) surgeries in terms of effectivity and complications.Material and methods: Preoperative data, duration of the operation, complications and postoperative visual analogue scores were noted. Patients were assessed 12 months after surgery. An objective cure was defined as a negative CST and no need for reoperation due to SUI. Subjective cure was defined as a PGI-I score ≤ 2. Symptom severity and QoL were measured using the total score and the total QoL score of the ICIQ-FLUTS.Results: Retrospectively 44 patients (A-TOT:29, A-TVT:15) were enrolled in this study. Mean follow-18 months. Preoperative parameters were similar. The VAS score at the 8th hour postoperatively was higher in the A-TOT group and similar at the 24 th h (p = 0.007 and p = 0.587, respectively). Grade 3 complications according to clavien dindo were only observed in the A-TOT group. At 12 month the objective cure rates according to CST were 96.5% and 100 the subjective cure rates according to PGI-I veew 96.5% and 100%. A positive CST finding was recorded in one patient (3.3%) in the A-TOT group. Total score and total quality of life (QoL) scores on the ICIQ-FLUTS were found to be significantly improved in both groups (p = 0.001 and p = 0.001, respectively) (Tab. 4). Similar improvements were found in both groups in the overall and quality of life subscores of the ICIQ-FLUTS filling and voiding sections (p = 0.476, p = 0.315, p = 0.520, and p = 0.448, respectively). Conclusions:The A-TOT technique has objective, subjective cure, and overall complication rates comparable to those of the A-TVT technique. The use of autologous fascia provides an opportunity to avoid mesh-related complications.

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“…TOT was performed with outside to inside technique as described by Delorme [11], and RT was performed with bottom to top technique as described by Ulmstein et al [12]. Our a-TOT procedure was performed with the technique which was previously published [13]. Briefly, we used a rectus abdominis muscle fascia in 5*1.5 cm, elongated with 2 separated nonabsorbable sutures in both edges of the fascia.…”

Section: Surgical Interventionsmentioning

confidence: 99%

Impact of Autologous Transobturator Sling Surgery on Female Sexual Function: A Comparative Study with Mesh Used Mid-Urethral Sling Surgeries

et al. 2021

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Introduction: To avoid mesh-related complications, autologous transobturator-tape (a-TOT) technique is a viable option in stress urinary incontinence (SUI) surgery. The method differs from TOT and retropubic tape (RT) in the usage of autologous tissue. We hypothesized that a-TOT improves female sexual dysfunction (FSD) more than TOT and RT. Methods: This is a retrospective cohort study. Patients who underwent a-TOT, TOT, and RT surgeries were surveyed regarding the cure of SUI, complications, and FSD parameters. The groups were compared according to baseline and postoperative data. Results: A-TOT, TOT, and RT groups included 37, 69, and 36 patients, respectively. The median follow-up time was 19 months. The groups were similar in terms of preoperative characteristics. The objective cure, subjective cure, and overall complication rates were comparable among the groups (p > 0.05). A-TOT group had significant improvements in mean female sexual function index (FSFI) scores, TOT group deteriorated, and RT group remained stable (p = 0.001, p = 0.001, and p = 0.226, respectively). The postoperative mean total FSFI scores were 25.73 ± 2.46, 23.17 ± 3.35, and 21.53 ± 2.47 for the a-TOT, TOT, and RT groups, respectively. The a-TOT group had better results than the TOT and RT groups (p < 0.05 and p < 0.05), and besides, the difference between the TOT and RT groups was statistically significant (p < 0.05). According to percentage changes in domain scores following the operations, the a-TOT group had significantly better results in desire, arousal, lubrication, satisfaction, and pain domains than the TOT group (p < 0.05) as well as better desire, arousal, and pain domains (p < 0.05) than the RT group. Discussion/Conclusions: Besides comparable outcomes in SUI treatment, the a-TOT technique provides improvements in female sexual functions while TOT worsens and RT does not change. Favorable outcomes in sexual functions caused by improvements in desire, arousal, satisfaction, and pain domains are observed following the a-TOT technique.

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Autologous transobturator midurethral sling

Cited by 5 publications

References 10 publications

Risk Factor of De Novo Urgency and Urge Incontinence After Autologous Fascia Pubovaginal Sling

Risk Factor of De Novo Urgency and Urge Incontinence After Autologous Fascia Pubovaginal Sling

Use of autologous fascia in midurethral sling surgeries; comparison of transobtrator and retropubic ways

Impact of Autologous Transobturator Sling Surgery on Female Sexual Function: A Comparative Study with Mesh Used Mid-Urethral Sling Surgeries

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