One-Year Follow-up of Tension-free Vaginal Tape (TVT) and Trans-obturator Suburethral Tape from Inside to Outside (TVT-O) for Surgical Treatment of Female Stress Urinary Incontinence: A Prospective Randomised Trial

Zullo, Marzio Angelo; Plotti, Francesco; Calcagno, Marco; Marullo, E.; Palaia, Innocenza; Bellati, Filippo; Basile, Stefano; Muzii, Ludovico; Angioli, Roberto; Panici, Pierluigi Benedetti

doi:10.1016/j.eururo.2006.10.066

Cited by 114 publications

(74 citation statements)

References 22 publications

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“…In contrast, recently published 5-year results from a randomized trial comparing TVT and TOT reported a long-term de novo urgency rate of 4% for first/s generation MUSs combined [18]. This was unchanged from the rate of de novo OAB at 1 year (4%) from the same trial, which was previously reported [19]. It is true that not all cases of de novo OAB are of similar severity as not every affected woman will be incontinent; in the largest trial included here, the incidence of de novo OAB was 7%, but none of these women had urge incontinence [10].…”

Section: Discussioncontrasting

confidence: 52%

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

Walsh¹

2011

BJU International

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What’s known on the subject? and What does the study add?Although synthetic mid‐urethral slings are now generally accepted as the first‐line surgical treatment of female stress incontinence, there is concern that newer slings are being used prematurely, before sufficient evidence exists. The 3rd generation “mini‐slings” are inserted via a single incision which, theoretically, reduces iatrogenic morbidity. It is vital, however, that efficacy is not compromised. To date, a number of papers have examined short‐term outcome data following the TVT‐Secur, with wide variations in reported cure rates at up to one year.This is the largest review of outcomes following TVT‐Secur published to date (n= 1178 cases from 10 studies). Cure rate, both objectively and subjectively, was 76%, which is similar to more established mid‐urethral slings. Intra‐operative vaginal perforation rates and rates of mesh exposure in the first 12 months post‐operatively were both 2%. The incidence of de novo OAB was 10%. No serious complications were recorded amongst this large cohort. Although the TVT‐Secur appears to be a safe procedure, its long‐term efficacy moving forward requires close scrutiny.• Synthetic mid‐urethral slings (MUSs) are considered the first choice surgical procedure for stress urinary incontinence. Recent publications have raised concerns about the efficacy of third generation single‐incision mini‐slings. The present paper is a systematic review of studies reporting 12‐month outcomes after the TVT‐Secur (TVT‐S) procedure.• Pubmed/Medline online databases, abstracts from recent International Continence Society and International Urogynecological Association annual scientific meetings and the Clinicaltrials.gov and Controlled‐trials.com online trial registries were searched for English‐language articles containing the terms ‘TVT‐Secur’, ‘TVT Secur’ or ‘mini‐sling’. The primary outcomes were objective and subjective cure rates at 12 months. Secondary outcomes included peri‐operative (vaginal perforation, urinary retention, urinary tract infection [UTI]) and postoperative (mesh exposure, de novo overactive bladder (OAB), dyspareunia and return to theatre) complication rates.• Among 1178 women undergoing the TVT‐S procedure, from 10 studies, both objective and subjective cure rate at 12 months was 76%, with objective cure significantly higher in women undergoing the ‘U‐type’ approach. Vaginal perforation was a complication in 1.5% of cases, with a 2.4% incidence of mesh exposure in the first year. The incidence of de novo OAB symptoms was 10%. Rates of urinary retention (2.3%), UTI (4.4%), dyspareunia (1%) and return to theatre for complications (0.8%) were low. In the first year after a TVT‐S procedure 5% of women required repeat continence surgery.• Longer‐term studies and randomized comparisons with more established MUSs are required before TVT‐S should be routinely used in the surgical treatment of stress urinary incontinence.

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Section: Discussioncontrasting

confidence: 52%

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

Walsh¹

2011

BJU International

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“…On one hand, the duration obtained in our study is in accordance with other practices in our country, as is shown in the recent study from Castroviejo-Royo et al, 18 who indicated a stay of 3.83±2.46 days in patients treated using TVT-TOT. Girvent et al 19 analyzed interventions with TVT-O, obtaining an average stay of 2.7 days, equal to what was reported by others, such as Úbeda et al 20 or Álvarez Cañadas et al 21 A slightly shorter stay was described by Navazo et al 22 (1.5 days, range: 1-5) or Zullo et al 23 (1, 1±0.3 days). However, the performance of the technique under anesthesia-sedation as an outpatient procedure has been described, 24 for which there was no stay.…”

Section: Discussionmentioning

confidence: 60%

Cost Effectiveness analysis of Surgical Treatment of Stress Urinary Incontinence Using Single-Incision Mini-Slings vs. Tension-Free Vaginal Obturator in Spain

Castañeda¹,

Sanz-Granda²,

Hidalgo³

et al. 2015

Surg Res Open J

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“…Comparative studies only observed bladder perforation among patients in retropubic groups, with rates of 3% to 6.5%. 14,16,20 In our study there were no cases of bladder perforation in either group.…”

Section: Discussionmentioning

confidence: 66%

“…Other authors have published contrasting results, however, indicating that the rate of complications is lower using the transobturator technique. 14,16,20 Studies have reported incidence rates of bladder perforation ranging from 0.8% to 21% among patients treated using the retropubic technique. 7,21,22 In contrast, few cases of bladder or urethra perforation are reported during transobturator surgery.…”

Section: Discussionmentioning

confidence: 99%

"Sling" retropúbico e transobturatório no tratamento da incontinênca urinária de esforço

Tanuri¹,

Feldner²,

Bella³

et al. 2010

Rev. Assoc. Med. Bras.

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Objective. To compare the results of retropubic and transobturator slings for surgical treatment of female stress urinary incontinence (SUI). MethOds. We randomized thirty patients with SUI, ten of whom underwent transobturator sling surgery and ten retropubic sling surgery. Patients were assessed before treatment and 1, 6 and 12 months after treatment on the basis of clinical history, physical examination, quality of life questionnaire (King's Health Questionnaire), pad test and urodynamic evaluation. The groups were homogenous prior to surgery. Results. One year after surgery, incontinence and quality of life parameters had improved significantly in both groups and there were no differences between them. There was a significant reduction in pad test weights in both groups. According to the urodynamic evaluation, 12 months after surgery cure rates were 84.2% for the transobturator group and 88.8% for the retropubic group. Subjective cure rates were 85% in the transobturator group and 88.8% in the retropubic group. No statistical difference was observed in complication rates. cOnclusiOn. Retropubic and transobturator slings were effective for treatment of women with SUI at 12-month follow-up. Both techniques had significant cure rates and improved quality of life with low complication rates.

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One-Year Follow-up of Tension-free Vaginal Tape (TVT) and Trans-obturator Suburethral Tape from Inside to Outside (TVT-O) for Surgical Treatment of Female Stress Urinary Incontinence: A Prospective Randomised Trial

Cited by 114 publications

References 22 publications

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

Cost Effectiveness analysis of Surgical Treatment of Stress Urinary Incontinence Using Single-Incision Mini-Slings vs. Tension-Free Vaginal Obturator in Spain

"Sling" retropúbico e transobturatório no tratamento da incontinênca urinária de esforço

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