Review on midurethral sling procedures for stress urinary incontinence

Karim, Nazura bt; Lo, Tsia‐Shu; Nawawi, Enie Akhtar; Wu, Pei‐Ying

doi:10.1016/j.gmit.2015.04.003

Cited by 5 publications

(9 citation statements)

References 39 publications

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“…TOT is a widely utilized, minimally-invasive technique that has proven its usefulness in patients with SUI; the technique is associated with optimal cure rates and diminished risks of major postoperative complications, such as injuries to surrounding structures and retention [ 3 , 5 ]. Previous reports showed that the TOT exhibited acceptable levels of cure rate and safety profile on long-term follow-up among women with SUI [ 8 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…TOT is thought to increase the risk of reoperation due to synthetic mesh, which may be exposed in the long term and need removal. The synthetic mesh may also lead to chronic pain and voiding dysfunction requiring reoperation [ 3 ]. Several risk factors were implicated in the need for reoperation among women undergoing TOT, such as obesity, diabetes, revision surgery, and mixed UI [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical procedures are widely performed for women with failed conservative management or women seeking definitive treatment [ 2 ]. Mid-urethral sling (MUS) is a highly effective, minimally-invasive, surgical approach for SUI that is based on the passing of a small band of a synthetic mesh into either the retropubic space (known as tension-free vaginal tape, TVT) or through the obturator foramen (known as trans-obturator tape, TOT or TVT-O, through the inside-out route) [ 3 ]. Previous reports showed that MUS achieves a cure rate of up to 94% [ 4 ], with a low risk of postoperative complications, such as visceral injuries and retention [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Two-year outcomes of surgeon-tailored trans obturator tape for female stress urinary incontinence: a randomized, comparative, trial with traditional trans obturator tape

Shebl

2021

BMC Urol

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Background Previously, we presented the short-term outcomes of surgeon-tailored mesh in patients with SUI undergoing TOT. In this report, we aim to highlight the two-year outcomes of surgeon tailored mesh in terms of subjective and objective cure rates, as well as late complications. Methods We performed a randomized, open-label comparative trial that recruited women with SUI who were scheduled to undergo TOT. Eligible patients were randomly allocated in a 1:1 ratio to receive traditional TOT mesh or surgeon-tailored polyethylene mesh. All patients were followed up for two years. Results At the end of the follow-up, there were 13 women in the traditional TOT mesh group and 14 patients in the surgeon-tailored polyethylene mesh group. Concerning the primary outcome of the present study, the cure rate was 100% in the surgeon-tailored polyethylene mesh (n = 14) and 92.9% in the traditional TOT mesh group (p = 0.39). One woman reported improved symptoms in the traditional TOT mesh group. There were no reported failures in both groups. Concerning safety, the incidence of de novo urgency was 0% in the surgeon-tailored polyethylene mesh group, compared to 7.1% in the traditional TOT mesh group (p = 0.34). None of the women in both groups reported mesh erosions, dyspareunia, or need for reoperation. Conclusion Surgeon-tailored mesh for patients undergoing TOT is a cost-effective technique, which has comparable long-term outcomes, in terms of cure rate and complications, to the traditional costly meshes. Larger multicentre studies should confirm our results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Two-year outcomes of surgeon-tailored trans obturator tape for female stress urinary incontinence: a randomized, comparative, trial with traditional trans obturator tape

Shebl

2021

BMC Urol

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“…The gold-standard in the treatment of SUI today is still the upward suspension of the descended urethra with the help of a 1 cm wide plastic band, the Tension-Free Vaginal Tape (TVT) in the retropubic tissue [6] (Figure 4). An estimated 260,000 sling procedures are performed annually in the U.S. [7].…”

Section: Sling/tape Proceduresmentioning

confidence: 99%

“…There is robust evidence to support the use of Mid-Urethral Sling (MUS) from over 2,000 publications, making this treatment the most extensively reviewed and evaluated procedure for female SUI now in use [6]. It is, however, acknowledged that any operation can cause complications.…”

Section: Sling/tape Proceduresmentioning

confidence: 99%

Injectable Bulking Agents for the Treatment of Stress Urinary Incontinence

Lemperle¹,

Lemperle²

2017

SM Gerontol Geriatr Res

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Urethral Bulking Agents (UBAs) are injected locally as a minimally invasive procedure for Stress Urinary Incontinence (SUI) and are beneficial for properly selected patients. Many different materials have been developed and are available, although none so far meet all the requirements of an ideal agent. The first UBA was cross-linked bovine collagen (Contigen ® ), followed by autologous fat injections, solid silicone particles (Macroplastique ® ), microspheres covered with pyrolytic carbon (Durasphere ® ), calcium hydroxyapatite (Coaptite ® ), polyacrylamide hydrogel (Bulkamid ® ), and dextran/HA copolymer (Zuidex ® ). The latest product development is PDMS-U, a silicone gel bulking agent that polymerizes in situ (Urolastic ® ).The ideal urinary bulking agent could consist of permanent microspheres, which immediately elicit a modest foreign body reaction along with the production of fibro-vascular tissue, which encapsulate every single microsphere individually and prevent their migration from the injection site. Polymethylmethacrylate microspheres have a successful history as dermal fillers used world-wide and can be safely injected submucosally at the urinary sphincter under direct vision, rather than peri-urethrally into the muscle like most of the present agents.Overall, short-term clinical results with most of the currently used urinary bulking agents are encouraging; however, longer follow-up results are often disappointing and retreatment is required. Proper patient selection and a safe, biocompatible and non-migrating bulking agent that elicits permanent fibro-vascular tissue formation at the injection site are paramount to successful treatment of stress urinary incontinence.

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Five-Years Outcomes of Different Procedures for The Treatment of Female Stress Urinary Incontinence: A Systematic Review and Network Meta-Analysis

Effat

Alkafrawy

Ahmed

et al. 2021

International Journal of Medical Arts

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Background:The current body of evidence is limited regarding the long-term outcomes of different modalities for stress urinary incontinence (SUI). We conducted this systematic review and network meta-analysis to compare the long-term follow-up outcomes of mid-urethral slings (MUS), Burch colpo-suspension, pubo-vaginal sling (PVS), anterior colporrhaphy with Kelly's plication, and laser therapy in the treatment of SUI. Aim of the work:The current work aimed to compare the long-term follow-up outcomes of the following modalities in the management of SUI: MUS, Burch colpo-suspension, PVS, SIMS, anterior colporrhaphy with Kelly's plication, bulking agents, and laser therapy. Methods:In this systematic review and network meta-analysis, we included prospective and retrospective studies that assessed the long-term outcomes of modalities for the management of SUI. We performed an online, bibliographic, search in four bibliographic databases: Cochrane Central Register of Controlled Trials (CENTRAL), Medline via PubMed, Web of Science, and Scopus.Results: A total of 42 studies were included. For the subjective cure rate, five different interventions were compared; pooling direct and indirect comparisons revealed an advantage of tension-free vaginal tape (TVT) intervention over TVT-obturator (TVT-O), laparoscopic Burch colpo-suspension, trans-obturator tape (TOT), and TVT-sling (TVT-S). Concerning objective cure rate, the pooling direct and indirect comparisons showed an obvious advantage of TOT, followed by TVT, and then TVT-O, Burch lap, and TVT-S. For repeated surgery, four different interventions were compared, and the comparisons revealed an advantage of TVT intervention over TVT-O, PVS, and TOT. The comparisons revealed the advantage of TVT and TVT-O over other procedures for lower urinary symptoms and postoperative complications.Conclusion: MUS appears to be the most effective and safe procedure for SUI at long-term follow-up. However, these findings should be interpreted with caution as there is scarcity in the published reports assessing long-term outcomes of other modalities, especially PVS and laser therapy.

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Review on midurethral sling procedures for stress urinary incontinence

Abstract: 1: Gynecologic oncologists as benign gynecologic surgeons

Cited by 5 publications

References 39 publications

Two-year outcomes of surgeon-tailored trans obturator tape for female stress urinary incontinence: a randomized, comparative, trial with traditional trans obturator tape

Two-year outcomes of surgeon-tailored trans obturator tape for female stress urinary incontinence: a randomized, comparative, trial with traditional trans obturator tape

Injectable Bulking Agents for the Treatment of Stress Urinary Incontinence

Five-Years Outcomes of Different Procedures for The Treatment of Female Stress Urinary Incontinence: A Systematic Review and Network Meta-Analysis

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