Retropubic tension-free vaginal tape and inside-out transobturator tape: a long-term randomized trial

Zhang, Zhibo; Zhu, Lan; Xu, Tao; Lang, Jinghe

doi:10.1007/s00192-015-2798-2

Cited by 35 publications

(54 citation statements)

References 30 publications

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“…Further sensitivity analyses limited to the 5 RCTs with follow-up durations >60 mo [21,34,[37][38][39] demonstrated similar outcomes for RP-TVT and TO-TVT in terms of objective cure rate, subjective cure rate, vaginal erosions, storage and voiding LUTS, and reoperation rates (see supplemental figure 1). …”

Section: Randomized Controlled Trials Comparing Retropubic With Transmentioning

confidence: 88%

“…Interestingly, Khan et al reported presence of scar pain also following autologous PVS, indicating that such risk is not limited to MUS [19]. Two recent studies reported 6.4% and 9% groin/inguinal pain/discomfort at 7 and 10-years follow-up respectively following TO-TVT [39,49]. Intractable suprapubic pain has been previously described following colposuspension and defined as post-colposuspension syndrome.…”

Section: Discussionmentioning

confidence: 99%

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Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

et al. 2017

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CONTEXT: Retropubic (RT-TVT) and transobturator miurethral (TO-TVT) mid-urethral sling (MUS) are popular surgical treatments for female stress urinary incontinence (SUI). The long-term efficacy and safety of the procedures is still a topic of intense clinical research and several randomized controlled trials (RCTs) have been published in the last years OBJECTIVE: To evaluate the efficacy and safety of MUS compared with other surgical treatments for female SUI. EVIDENCE ACQUISITION:A systematic review and meta-analysis of the literature was performed using the Medline, Scopus, and Web of Science databases to update our previously published analyses. EVIDENCE SYNTHESIS:Twenty-eight RCTs were identified. In total, the meta-analyses CONCLUSIONS:The present analysis confirms the superiority of MUS over BC. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of 3 inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT. PATIENT SUMMARY:Retropubic and transobturator midurethral slings are a popular treatment for female stress urinary incontinence. The available literature suggest that those slings are either more effective or safer than other older surgical procedures. Retropubic tapes are followed with slightly higher continence rates as compared with the transobturator tapes but are associated with higher risk of intra-and postoperative complications. TAKE-HOME MESSAGESThe present analysis confirms the superiority of MUS over Burch colposuspension. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT 4

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Section: Randomized Controlled Trials Comparing Retropubic With Transmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

et al. 2017

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“…The majority of the studies in the literature did not present these outcomes. While Albo et al reported persisting pain for more than 6 weeks in 2.17% of their cohort at 2 years, Zhang et al reported significant pain in 9.16% at 5 years and Ross et al substantial pain in 18.78% at 5 years. Regarding sexual function, although the available literature suggests an overall postoperative improvement, de novo dyspareunia has been shown to affect 6.66% to 8.82% of women.…”

Section: Methodsmentioning

confidence: 94%

“…While the cure rates of the two procedures are similar, the insertion of TO‐MUS has been associated with a lower risk of bladder perforation and voiding dysfunction and a higher risk of groin pain and repeat continence surgery. Long‐term outcomes were reported by six RCTs of TO‐MUS vs RP‐MUS …”

Section: Methodsmentioning

confidence: 99%

“…The recent controversy about the use of MUS has originated from the risk of mesh‐related complications, such as vaginal exposure/extrusion and internal organ perforation . The reported rate of these complications in the RCTs with 5 year follow‐up varies significantly; 0.36%, 2.94%, 5.36%, 5.45%, and 5.83% . In these studies, the complications were not described based on the joint ICS/IUGA terminology and classification and therefore their implications were not clear.…”

Section: Methodsmentioning

confidence: 99%

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Do we need better information to advise women with stress incontinence on their choice of surgery? Report from the ICI‐RS 2018

Giarenis

Malde

Harding

et al. 2019

Neurourology and Urodynamics

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Aims:The regulatory warnings about the safety of the synthetic midurethral slings (MUS) had a significant effect on how patients and physicians approach surgical management of stress urinary incontinence (SUI). In this changing landscape, the purpose of this research Think Tank (TT) was to provide an update of the current knowledge about the safety and efficacy of SUI surgery, to review patient goals and expectations and to identify factors affecting the decision making for surgery.Methods: This is a consensus report of the proceedings of TT3: "Do we need better information to advise women with stress incontinence on their choice of surgery?" from the annual International Consultation on Incontinence-Research Society (ICI-RS), June 2018. Results: Despite the body of evidence supporting the continued use of MUS, the short follow-up of most of the studies and the lack of "real life" data regarding pain and sexual dysfunction make the development of recommendations challenging. Women with SUI are often happy to "trade" efficacy for a procedure with less associated morbidity and therefore it is not always the procedure with the highest success rate that is ultimately chosen. However, a number of factors influence treatment decision and there is limited evidence about what level of all these factors women are willing to tolerate for a given success rate, or how much success they are willing to trade for a lower complication rate. Conclusions: The ICI-RS proposed research questions which may be able to assist in improving the counseling and management of women with SUI.

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Long‐term efficacy follow‐up of tension‐free vaginal tape obturator in patients with stress urinary incontinence with or without cystocele

Bakas

Papadakis

Karachalios

et al. 2018

Intl J Gynecology & Obste

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Objective To assess the long‐term outcomes of tension‐free vaginal tape obturator (inside‐out) (TVTO) with or without anterior colporrhaphy. Methods The present prospective follow‐up observational study included patients attending the 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Greece, between April 3 and December 20, 2017, for follow‐up care after treatment for urodynamic stress urinary incontinence (USUI) with or without cystocele. Patients without cystocele had been treated with TVTO only; those with cystocele underwent TVTO with anterior colporrhaphy. The primary outcome was the objective cure rate assessed by the cough stress test during filling cystometry. Results Follow‐up data were available for 70 patients who underwent TVTO only and 38 who underwent TVTO and anterior colporrhaphy. The mean follow‐up period was 13 years. Objective cure was achieved for 57 (81%) patients in the TVTO‐only group and 32 (84%) patients in the TVTO and anterior colporrhaphy group. Regarding cystocele management, objective cure was recorded for 35 (92%) patients. Conclusion At 13‐year follow‐up, anterior colporrhaphy demonstrated a cure rate of 92% in the management of cystocele, and 84% in the management of cystocele and USUI when combined with TVTO. TVTO alone for the management of USUI had an objective cure rate of 81%.

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Retropubic tension-free vaginal tape and inside-out transobturator tape: a long-term randomized trial

Abstract: In the long term, the proportion of patients with complications and the cure rates of the two procedures did not differ significantly. The long-term complication rates were high, but morbidity was low, and the QOL remained improved.

Cited by 35 publications

References 30 publications

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

Do we need better information to advise women with stress incontinence on their choice of surgery? Report from the ICI‐RS 2018

Long‐term efficacy follow‐up of tension‐free vaginal tape obturator in patients with stress urinary incontinence with or without cystocele

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