Medium Term Outcomes of TVT-Abbrevo for the Treatment of Stress Urinary Incontinence: Efficacy and Safety at 5-Year Follow-Up

Abstract

Background and objectives: Stress urinary incontinence (SUI) is the most common type of urinary incontinence, affecting approximately 46% of adult women. After failure of conservative treatment, the mid-urethral sling (MUS) is considered the most effective and safe surgical procedure for SUI. In 2012, Waltregny et al. introduced a new trans-obturator tension-free vaginal tape (TVT) procedure, named TVT-abbrevo (TVT-A). The aim of the present study is to evaluate the efficacy and safety of the TVT-A procedure in women with pure SUI at 5-year follow-up. Materials and Methods: All women who complained of pure SUI symptoms with concomitant urodynamic stress incontinence (USI) were prospectively enrolled and treated with the TVT-A procedure. Postoperative subjective outcome measures included: International Consultation on Incontinence Questionnaire–Short Form (ICI-Q SF), Patient Global Impression of Improvement (PGI-I) scale, and patient degree of satisfaction scale. A PGI-I score ≤2 and a patient-satisfaction score ≥8 were used to define subjective success. Objective success was defined as the absence of urine leakage during a cough stress test. Adverse events were collected according to the Clavien–Dindo classification during follow-up. Results: Univariable analysis was used to investigate outcomes. Fifty women who met the inclusion criteria underwent TVT-A implantation. At 5 years after TVT-A implantation, 38 out of 45 (84.4%) patients were subjectively cured (p for trend 0.05), and 40 out of 45 (88.9%) patients were objectively cured (p for trend 0.04). A significant trend of de novo OAB symptoms was reported (22.2% [10/45]) at the 5-year follow-up. No serious early or late complications such as urethral/bladder injury, persistent groin-thigh pain, and sexual dysfunction that required mesh removal were detected. The univariate analysis did not reveal any risk factors (i.e., age, body mass index (BMI), menopause, obstetric factors, and preoperative ICIQ- SF questionnaire) statistically associated with failure of the TVT-A procedure. Conclusions: In conclusion, the 5-year follow-up results of this study demonstrated that TVT-A is a safe and effective option for treatment of SUI with a very low rate of post-operative groin–thigh pain

Flat Magnetic Stimulation for Stress Urinary Incontinence: A Prospective Comparison Study

“…Surgical treatment is indicated when conservative management fails. Many types of surgery have been proposed over the years, including bladder neck suspension, anterior vaginal wall repair, autologous sling, stem cell injection, urethral bulking agents, and suburethral tapes [ 19 , 20 , 21 , 22 , 23 ]. However, each surgical approach has its own drawbacks, including visceral injuries (such as bladder perforation) and chronic neurological pain [ 24 , 25 ].…”

Flat Magnetic Stimulation for Stress Urinary Incontinence: A 3-Month Follow-Up Study

“…According to the guidelines, conservative measures are considered the first-line choice, while surgical treatment is usually considered after the failure of conservative management. Different surgical options can be proposed for the treatment of SUI, such as anterior compartment repairs, bladder neck suspensions, midurethral slings, and injections [ 21 , 22 , 23 , 24 , 25 ]. To date, midurethral slings are considered the first option because of their high efficacy rates [ 26 ].…”

Urethral Injury After Vaginal Birth and Stress Urinary Incontinence: Bulking Agents are Feasible Options

“… 5 Among surgical techniques, mid-urethral slings are considered the gold standard of treatment, due to their long-term efficacy. 6 , 7 However, despite high efficacy and low complication rates, debates have been raised regarding mesh-related adverse sequelae, leading to the 2018 UK ban of midurethral tape. 8 , 9 Consequently, alternative anti-incontinence procedures have been evaluated, with a particular interest in the urethral bulking agents (UBAs) as a minimally invasive alternative technique in the management of SUI.…”