Functional and quality of life outcome of transobturator tape for treatment of female stress urinary

Shaker, Hassan; Ban, Hesham M.; Hegazy, A S; Mansour, Magdy Fathallah

doi:10.1007/s00192-010-1238-6

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…Both the TOT and TVT-O procedures proved to have high success rates in short and medium term follow-ups and to be associated with few perioperative complications ( 9 , 10 ). However, the use of transobturator slings is associated with specific complications such as thigh pain ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison between the retropubic and transobturator approaches in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications

et al. 2015

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Objective This study aimed to compare the effectiveness and complications between the retropubic and transobturator approaches for the treatment of female stress urinary incontinence (SUI) by conducting a systematic review.Materials and Methods We selected all randomized controlled trials (RCTs) that compared retropubic and transobturator sling placements for treatment of SUI. We estimated pooled odds ratios and 95% confidence intervals for intraoperative and postoperative outcomes and complications.Results Six hundred twelve studies that compared retropubic and transobturator approaches to midurethral sling placement were identified, of which 16 were included in our research. Our study was based on results from 2646 women. We performed a subgroup analysis to compare outcomes and complications between the two approaches. The evidence to support the superior approach that leads to better objective/subjective cure rate was insufficient. The transobturator approach was associated with lower risks of bladder perforation (odds ratio (OR) 0.17, 95% confidence interval (CI) 0.09-0.32), retropubic/vaginal hematoma (OR 0.32, 95% CI 0.16-0.63), and long-term voiding dysfunction (OR 0.32, 95% CI 0.17-0.61). However, the risk of thigh/groin pain seemed higher in the transobturator group (OR 2.53, 95% CI 1.72-3.72). We found no statistically significant differences in the risks of other complications between the two approaches.Conclusions This meta-analysis shows analogical objective and subjective cure rates between the retropubic and transobturator approaches to midurethral sling placement. The transobturator approach was associated with lower risks of several complications. However, good-quality studies with long-term follow-ups are warranted for further research.

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Section: Introductionmentioning

confidence: 99%

Comparison between the retropubic and transobturator approaches in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications

et al. 2015

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Recent Developments in the Surgical Management of Urinary Stress Incontinence

Ahn

Alvarez

Dwyer

2013

Curr Obstet Gynecol Rep

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Surgical management continues to be the mainstay of treatment for patients with moderate to severe stress urinary incontinence who are nonresponsive to conservative measurements. In the past, the Burch colposuspension was considered the first line of treatment; however, since the introduction of mid-urethral slings in the mid 1990s the retropubic sling has become the "gold standard." Tension-free vaginal tape (TVT) is the original retropubic procedure with good long-term efficacy and safety data available. However, in an attempt to decrease the risk of retropubic complications, such as vascular, bowel, or bladder injury, the transobturator and single incision minislings have been described. In this review, we give an overview on the recent data available on conventional anti-incontinence procedures as well as other more recently developed procedures. Recent studies with more than 10 years of follow-up continue to confirm the effectiveness of the TVT sling in the long-term, which the other approaches need to match.

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Safety considerations for synthetic sling surgery

et al. 2015

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Implantation of a synthetic midurethral sling (SMUS) is the most commonly performed anti-incontinence operation in women worldwide. The effectiveness of the SMUS is comparable to that of the historical gold standards--autologous fascial slings and the Burch colposuspension. Much controversy, however, has evolved regarding the safety of this type of sling. Overall, the quality of the studies with respect to assessing risks of SMUS-associated complications is currently poor. The most common risks in patients with SMUS include urethral obstruction requiring surgery (2.3% of patients with SMUS), vaginal, bladder and/or urethral erosion requiring surgery (1.8%) and refractory chronic pain (4.1%); these data likely represent the minimum risks. In addition, the failure rate of SMUS implantation surgery is probably at least 5% in patients with stress urinary incontinence (SUI). Furthermore, at least one-third of patients undergoing sling excision surgery develop recurrent SUI. Considering the additional risks of refractory overactive bladder, fistulas and bowel perforations, among others, the overall risk of a negative outcome after SMUS implantation surgery is ≥15%.

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Functional and quality of life outcome of transobturator tape for treatment of female stress urinary

Abstract: TOT (outside-in) appears to have no deleterious effect on storage and voiding functions.

Cited by 4 publications

References 14 publications

Comparison between the retropubic and transobturator approaches in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications

Comparison between the retropubic and transobturator approaches in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications

Recent Developments in the Surgical Management of Urinary Stress Incontinence

Safety considerations for synthetic sling surgery

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