Functional Results After the Suburethral Sling Procedure for Urinary Stress Incontinence: A Prospective Randomized Multicentre Study Comparing the Retropubic and Transobturator Routes

Daraı̈, Émile; Frobert, J.L.; Grisard-Anaf, Maryelle; Lienhart, Jean; Fernandez, H.; Dubernard, Gil; David-Montefiore, Emmanuel

doi:10.1016/j.eururo.2006.08.046

Cited by 60 publications

(27 citation statements)

References 22 publications

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“…The reported objective cure rates after MUS surgery are between 70 and 90%, changing according to definition of cure and follow-up time [17,18,19]. Our objective cure rates appear to be slightly higher than these values and also some of the previously reported randomized studies on Turkish women [20] in which objective cure rates at 12 months were 89 and 87% for RP and TO tapes, respectively.…”

Section: Discussioncontrasting

confidence: 41%

Safety and Efficacy of Retropubic or Transobturator Midurethral Slings in a Randomized Cohort of Turkish Women

Tarcan¹,

Mangır²,

Şahan³

et al. 2014

Urol Int

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Objective: The aim of this study was to evaluate the safety and efficacy of retropubic (RP) or transobturator (TO) midurethral slings (MUS) in a prospective randomized cohort of Turkish women. Patients and Methods: A total of 54 women with urodynamic stress urinary incontinence (SUI) were randomized to undergo either RP or TO MUS between August 2006 and February 2013 in a tertiary referral center by a single surgeon. All patients had history, physical examination, urodynamic evaluation and quality of life assessments. The validated Turkish versions of the SEAPI, ICIQ-SF and OAB-V8 questionnaires were used. The Advantage® RP and the Obtryx® TO MUS Systems were used for all RP and TO procedures. Results: Twenty-seven patients were randomized to each group. The median follow-up was 48.5 ± 21.8 months. The median hospital stay was 24.0 ± 4.8 h and median operative time was 35.0 ± 19.9 min. The overall objective and subjective cure rates were 92.6 and 79.6%, respectively. The quality of life of all patients significantly increased after the operation compared to their preoperative status. Patients with a poorer subjective cure rate were those with mixed urinary incontinence, whose preoperative SEAPI and OAB-V8 scores were significantly higher. Conclusion: MUS surgery is highly effective and could safely be performed in a cohort of Turkish women with SUI in subspecialty centers by experienced surgeons. There is no significant difference between RP or TO applications in terms of safety and efficacy. Further studies with long-term follow-up data are required.

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Section: Discussioncontrasting

confidence: 41%

Safety and Efficacy of Retropubic or Transobturator Midurethral Slings in a Randomized Cohort of Turkish Women

Tarcan¹,

Mangır²,

Şahan³

et al. 2014

Urol Int

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“…De Leval reported less intraoperative complications with his new technique. Several reports have been published on the short-and medium-term effectiveness of the procedure [7][8][9][10] as well as its relatively lower perioperative morbidity when compared with TVT [11][12][13]. However most of these studies have limited follow-up periods, and none of them have assessed the impact of TOT on patients' sexual life.…”

Section: Introductionmentioning

confidence: 95%

Transobturator suburethral tapes in the management of urinary incontinence: success, safety and impact on sexual life

Abdel‐Fattah¹,

Ramsay²,

Pringle³

et al. 2007

Gynecol Surg

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This study aims to assess transobturator tensionfree vaginal tapes (TOT) in regard to subjective cure rates, patient satisfaction, long-term morbidity and impact on patients' sexual life. It also aims to compare the safety profile of two TOTs: Obtape (outside-in technique) vs. TVT-O (inside-out technique). This is a retrospective study of all patients who had a TOT procedure for the management of urodynamic stress incontinence (USI) in a tertiary referral centre between July 2002 and January 2005. All patients identified from theatre records were sent an anonymous validated assessment questionnaire including the urinary domain of Birmingham Bowel and Urinary Symptoms Questionnaire, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Sexual Impact Questionnaire and a visual analogue scale (VAS) to assess patients' satisfaction. Case notes were examined to ascertain preoperative urodynamic diagnosis and perioperative complications. Two hundred and seventy-six women were identified from theatre records: 94 patients underwent TVT-O and 182 underwent Obtape . Mean age was 49 (range 34-78) years, and mean parity was two (range: 0-6). There was no difference between groups in regard to body mass index, urodynamic diagnosis and previous incontinence surgery. Intraoperative complications included bladder injury 0.4%, urethral injury 0.7%, lateral vaginal tears 4.3% and blood loss >200 ml in 5.4%. There was no statistically significant difference in intraoperative (p=0.2) and early postoperative (p=0.65) complications between groups. Late postoperative complications were mainly related to the tape material and included de novo urgency (6.9%), vaginal erosions (5.1%) and ischiorectal abscess (1.1%). A significantly higher rate of late postoperative complications occurred in the Obtape group (p=0.047). Median follow-up was 28 ± standard deviation(SD) 4.8 (range 10-40) months. Subjective success rate, defined as absent or occasional episodes of incontinence according to the ICIQ-SF was 86% in the USI group compared with 52.4% in the mixed incontinence group (p<0.001). Following the operation, there was no significant change in patients' sexual life as regards frequency of intercourse and pleasure and/or pain during penetration (p=1.000), whereas there was significant decrease in coital incontinence (p< 0.0001). TOT is a relatively safe procedure in the treatment of USI and is associated with a high subjective success rate with a median follow-up of 28 months. Coital incontinence is likely to be cured, and the vast majority of women described an improvement or no change in their sexual life following the TOT procedure. There was no significant difference in the complication rates between the outside-in vs. the inside-out techniques; however, significantly more "tape-related complications" occurred in the Obtape group.

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“…As far as sexual activity is concerned, there is no signi cant change in patients' sexual life. Darai et al, conducted a prospective randomized trials comparing TOT sling with TVT and have shown equivalent cure rate but there is lower complication in TOT approach 17 . In the transobturator approach, the path of the tape, crossing the obturator foramen, muscle, and fascia, reproduces the natural sub urethral suspension by reinforcing the rotational pivot point, restoring continence while sparing the retropubic space 18 .…”

Section: Discussionmentioning

confidence: 99%

Early Experience with Transobturator Tape in Management of Female Stress Urinary Incontinence

Hamal

Bhandari

Thapa

2013

Med. J. Shree Birendra Hosp.

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Functional Results After the Suburethral Sling Procedure for Urinary Stress Incontinence: A Prospective Randomized Multicentre Study Comparing the Retropubic and Transobturator Routes

Cited by 60 publications

References 22 publications

Safety and Efficacy of Retropubic or Transobturator Midurethral Slings in a Randomized Cohort of Turkish Women

Safety and Efficacy of Retropubic or Transobturator Midurethral Slings in a Randomized Cohort of Turkish Women

Transobturator suburethral tapes in the management of urinary incontinence: success, safety and impact on sexual life

Early Experience with Transobturator Tape in Management of Female Stress Urinary Incontinence

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