Repeat Synthetic Mid Urethral Sling Procedure for Women With Recurrent Stress Urinary Incontinence

Stav, Kobi; Dwyer, Peter; Rosamilia, Anna; Schierlitz, Lore; Lim, Yujin; Chao, Fay; Souza, Alison De; Thomas, Elizabeth; Murray, Christine; Conway, Christine; Lee, Joseph

doi:10.1016/j.juro.2009.08.111

Cited by 111 publications

(92 citation statements)

References 17 publications

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“…To prevent the movement of urethra and support urethra against increased abdominal pressure, polyprolen mesh is placed in the obturator foramen in TOT procedure with a route of the trocar that avoid potential complications as bladder, bowel and vessels injuries (16). 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).…”

Section: Discussionmentioning

confidence: 96%

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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Section: Discussionmentioning

confidence: 96%

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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“…The authors later reported a 3-year follow-up of this study in which 20 % of the transobturator group underwent repeat surgery compared with 1.4 % of the retropubic group [22]. Although repeat surgery is a very clinically relevant outcome measure, it is highly subject to physician biases and the potential bias in this study is that: 1) the physicians were not blinded to the initial surgical procedure; 2) they were already aware of their 6-month results suggesting that subjects with transobturator procedures were more likely to request repeat surgery; 3) and their salvage operation was a retropubic sling [23]. It is very likely that physicians would be more willing to perform a retropubic operation on someone who had a prior transobturator procedure than those who already had a retropubic sling.…”

Section: Evaluation Of Urethral Functionmentioning

confidence: 97%

Role of Urodynamics in the Evaluation of Urinary Incontinence and Prolapse

Nager

2013

Curr Obstet Gynecol Rep

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Urodynamics are functional tests of the bladder that are commonly requested for the evaluation of urinary incontinence and prolapse. As a diagnostic test that also can provide prognostic information, urodynamics should be requested when there is a specific question that needs to be answered. This chapter will review the literature that pertains to the common reasons for requesting urodynamics before stress urinary incontinence surgery and review recent randomized trials on urodynamic testing before stress incontinence surgery. In addition, the chapter will compare the predictive ability of urodynamic prolapse reduction stress testing with office-based prolapse reduction stress testing for detecting postoperative stress urinary incontinence in women without symptoms of stress urinary incontinence undergoing prolapse surgery.

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“…Retropubic MUS however have been shown to be more effective than transobturator slings for recurrent SUI in patients who have failed a previous transobturator sling in recurrent SUI associated with ISD and following a Burch colposuspension [86,87].…”

Section: Management Of Recurrent Suimentioning

confidence: 99%

“…In a retrospective study of 1,225 women who underwent a MUS procedure with a mean follow-up of 5 years, Stav et al [87] reported a subjective success rate of 86% for primary sling versus 62% in the repeat-sling group (p <0.001). The repeat retropubic approach was significantly more successful than the repeat transobturator approach (71% vs. 48%, p = 0.04).…”

Section: Management Of Recurrent Suimentioning

confidence: 99%

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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Repeat Synthetic Mid Urethral Sling Procedure for Women With Recurrent Stress Urinary Incontinence

Cited by 111 publications

References 17 publications

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

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

Role of Urodynamics in the Evaluation of Urinary Incontinence and Prolapse

Recent Developments in the Surgical Management of Urinary Stress Incontinence

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