Randomised prospective single‐blinded study comparing ‘inside‐out’ versus ‘outside‐in’ transobturator tapes in the management of urodynamic stress incontinence: 1‐year outcomes from the E‐TOT study

Abdel‐Fattah, Mohamed; Ramsay, Ian; Pringle, Stewart; Hardwick, Chris; Ali, Hassan; Young, David; Mostafa, Alyaa

doi:10.1111/j.1471-0528.2010.02544.x

Cited by 76 publications

(56 citation statements)

References 36 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: 40%

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: 40%

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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“…Stav et al demonstrated a 86% success rate after TOT surgery in their series of 1225 patients (17). Some surgeon reported up to 91% cure rate after one year follow up (18). In this study, we achive 84 % cure rate after one year follow up period.…”

Section: Discussionsupporting

confidence: 60%

Evaluation of per-operative cough stress test during transobturator mid-urethral sling surgery

Şimşek

Kireççi

Bayar

et al. 2017

Arch Ital Urol Androl

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This study has been presented in EAU 2015 Meeting in Madrid.Purpose: Currently, it is unclear how the mesh tension should be adjusted on the transobturator tape surgery (TOT) for improving continence. The aim of this study was to evaluate the effects of per-operative cough stress test on TOT. Materials and methods: Between March 2007 and December 2011, 206 women with SUI were enrolled in this study. Patients were randomly categorized to treatment with TOT (96) or TOT with cough stress test (110). The IIQ-7 and the UDI-6 were used to identify satisfaction level. At the end of 1st year, two groups were compared patient characteristics, operation time, duration of hospital stay, cure and complication rates. Results: The cure rate was 84.37% 81/96) versus 83.63% (92/110) in TOT and TOT with cough test groups, respectively. Postoperatively ten patient (10/110, 9.09%) suffered voiding difficulties (> 250 ml residual urine) in TOT with cough stress test group. Five patients were discharged with transurethral catheter, whereas, in traditional TOT group, two patients (2/96, 2.1%) had transient postoperative voiding difficulty and two patients were treated with repeated catheterization for 1 week (p < 0.05). Postoperative groin pain was present in 7/96 (8%) versus 24/110 (22%) in TOT and TOT with cough test groups, respectively (p < 0.05). TOT with cough stress test group had an higher rate of complications like, retention of urine, necessitating to cut the tape, mesh erosion and pain in groin or leg. No patient had resistant voiding difficulty or prolonged urinary retention (> 1 week) in traditional TOT group. Conclusions: We believe that per-operative cough stress test leads to overtreatment of stress urinary incontinence when the complication rates were considered. KEY WORDS: Cough stress test; Transobturator tape; Stress urinary incontinence (SUI). time and hospitalisation time, TOT has a high success rate up to 90% with lower complication rate (6-7). Although TOT is a safe and favorable for surgery for SUI, success of procedure is related with age, body mass index (BMI), diabetes mellitus, intrinsic sphincter deficiency and concomitant prolapsus surgery (8-9). Also urodynamic parameters including Q max , maximum urethral closure pressure and Valsalva leak point pressure have effects on operation success (10). Additionally, achieve adequate mesh tension is the one of most important point to prevent urinary incontinence. For assessment of the mesh tension, cough stress test (CST) is used intreoperatively while TOT procedure (11). As less tension is associated with leaving the patient incontinent, more tension may cause voiding disorders (12). In this study, we evaluated affect of CST on TOT procedure success rate and patients quality of life with using the Incontinence Impact Questionnaire and Urinary Distress Inventory Questionnaire. Also we assessed the effect of the adjustment of mesh tension with using CST on postoperative voiding disorders.

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“…The authors concluded that both of these approaches were equally safe and clinically effective. Another randomized prospective study, [20] compared TVT and TOT patients, and did not determine a significant difference in terms of objective cure rate [21]. In our study, no significant difference in the objective cure rates of the patients in both groups (objective cure rate of the mesh group 85% and of the mesh free group 82% at the end of 24 month follow up).…”

Section: Discussionmentioning

confidence: 52%

Female Stress Urinary Incontinence Treatment by Forming an Uretro-Vesical Angle with or without Mesh

Kılınç¹,

Göğer²

2017

OJOG

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Objective: To evaluate, in a comprehensive way, mesh and mesh free SUI treatment results obtained in a single center. The present study addresses the efficacy and safety of a novel surgical technique. Material & Methods: Adult female SUI patients, 184 in total, were divided within a sequential manner into two groups to be treated for SUI either with or without mesh insertion during a surgical intervention. In this novel procedure, a vertical vaginal incision from the urethra towards the bladder bottom is made and closed transversely. After the intervention the patients revisited the clinic at the 6 th month.Results: 81 patients in mesh and 83 in the mesh free group completed the 2-year follow up. Based on the pad tests conducted at the end of 24-month follow up, 82% of the patients in the mesh free group and 85% in the mesh group were considered as successful if the pad test resulted with ≤2 gram. Cystocele of Grade I or II was also treated in 69 patients within the same single surgical procedure. Conclusion: The surgical outcomes of the mesh and mesh-free group were almost the same. However, though the cure rate of the mesh group was higher, it was not statistically significant. Adverse events were more frequent in the mesh group due to mesh presence.

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Randomised prospective single‐blinded study comparing ‘inside‐out’ versus ‘outside‐in’ transobturator tapes in the management of urodynamic stress incontinence: 1‐year outcomes from the E‐TOT study

Cited by 76 publications

References 36 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

Evaluation of per-operative cough stress test during transobturator mid-urethral sling surgery

Female Stress Urinary Incontinence Treatment by Forming an Uretro-Vesical Angle with or without Mesh

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