Surgical Therapeutic Index of Tension-Free Vaginal Tape and Transobturator Tape for Stress Urinary Incontinence

Jeon, Minhyon; Chung, Doo Yong; Park, Joo Hyun; Kim, Sei Kwang; Kim, Jae Wook; Bai, Sang Wook

doi:10.1159/000107491

Cited by 9 publications

(5 citation statements)

References 37 publications

(23 reference statements)

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“…The analysis divided by treatment showed that, at 1 year of follow-up, TVT-O was effective in 83% of patients and TVT in 100% of them in the short-term (p<0.001), different to previous literature data that showed similar cure rates among techniques [17,[24][25][31][32], but almost similar to the study of O'Connor and colleagues that found an overall cure rates of 77% for TVT-O [33]. Furthermore, the subgroup analysis of SUI severity showed that all patients insufficiently cured were affected by SUI2 and treated with TVT-O (only 66% cured), while the others (SUI1/TVT-O and SUI1-2/TVT patients) had 100% cure rates.…”

Section: Discussioncontrasting

confidence: 78%

“…All studies that directly compared them found similar results in terms of cure [17,[24][25][31][32], and three of them also found important differences for the occurrence of postoperative complications [17,[31][32]. A recent meta-analysis confirmed similar positive results among techniques, although commented that "the poor quality of most of the studies, both in terms of methodology and clinical parameters, limited the strengths of the recommendations..." [16].…”

Section: Discussionmentioning

confidence: 95%

“…SUI was classified into three grades considering the severity of symptoms referred (SUI1=loss of urine during excessive strains, SUI2=during minor strains, SUI3=at rest) and the urodynamic evaluation [McGuire classification: SUI1= abdominal leak-point pressure (ALPP) greater than 90 cm water, SUI2=ALPP of 60-90 cm water, SUI 3=intrinsic sphincter deficiency and ALPP less than 60 cm water] [19][20][21][22]. The patients were classified according to the SUI system on the basis of urodynamics studies (McGuire classification), performed at 250 cc bladder volume [16,19,[24][25].…”

Section: Methodsmentioning

confidence: 99%

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TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence

et al. 2008

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TVT-O and TVT were compared in patients stratified according the severity of Stress Urinary Incontinence (SUI). Those patients with intrinsic sphincter deficiencies, overactive bladders, associated prolapses, neurovegetative disorders and recurrent SUI or under rehabilitative/medical therapies were all excluded. There were 208 women included. Operating times were longer, and postoperative pain greater for TVT (p < 0.001). TVT produced longer hospitalizations in severe SUI patients (p < 0.001). After 1 year of follow-up, incontinence was cured in all mild SUI patients with both techniques, in all severe SUI patients when treated with TVT and in 66% of them when treated with TVT-O (p < 0.001). Vaginal perforations occurred during the TVT-O (p = 0.01), bladder perforations during TVT (p = NS), bladder obstructions in mild SUI patients after TVT (p < 0.001). The severity of SUI is an important parameter that influences results after TVT-O and TVT, and could be used to guide surgeons in selecting the most effective intervention.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

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TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence

et al. 2008

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“…[16] However, some studies have shown that low MUCP and/or VLPP were associated with increased failure with the transobturator route. [11][17] [18] [19] [20] [21]Schierlitz et al randomized women with poor urethral function (MUCP ≤ 20 cm H20 and /or delta VLPP of ≤ 60 cm/H20) to retropubic or transobturator procedures. [22]Postoperative USI at 6 months was less in the retropubic (21%) than the transobturator groups (45%) ( p = 0.004).…”

Section: Discussionmentioning

confidence: 99%

Baseline Urodynamic Predictors of Treatment Failure 1 Year After Mid Urethral Sling Surgery

Nager

Sirls²,

Litman

et al. 2011

Journal of Urology

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Purpose We determined whether baseline urodynamic study variables predict failure after midurethral sling surgery. Materials and Methods Pre-operative urodynamic study variables and post operative continence status were analyzed from women participating in a randomized trial comparing retropubic to transobturator midurethral sling. Objective failure was defined by positive standardized stress test, or 15 ml or greater on 24-hour pad test, or re-treatment for stress urinary incontinence (SUI). Subjective failure criteria were self-reported stress symptoms, or leakage on 3-day diary, or retreatment for stress urinary incontinence. Logistic regression assessed associations between covariates and failure controlling for treatment group and clinical variables. Receiver operator curves were constructed for relationships between objective failure and measures of urethral function. Results Objective continence outcomes were available at 12 months from 565 of 597 (95%) women. Treatment failed in 260 (245 subjective criteria, 124 by objective criteria). No urodynamic variable was significantly associated with subjective failure on multivariate analysis. Valsalva leak point pressure (VLPP) and maximum urethral closure pressure (MUCP) were the only urodynamic variables consistently associated with objective failure on multivariate analysis. No specific cut-point was determined for predicting failure for VLPP or MUCP by ROC; the lowest quartile (VLPP <86 cm H2O; MUCP <45 cm H2O) conferred an almost two fold increased odds of objective failure regardless of sling route [OR 2.23 (1.20– 4.14) for VLPP and OR 1.88 (1.04–3.41)] for MUCP. Conclusions Women with either a VLPP or MUCP in the lowest quartile are nearly 2-fold more likely to experience SUI one year after transobturator or retropubic MUS.

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“…9,261 In addition, the qualifiers persistent or de novo 261 were often used. De novo OAB, indicating the occurrence of OAB after sling surgery, was reported in 0-48% of patients in various studies (REFS 17,18,20,26,39,(46)(47)(48)(50)(51)(52)(53)55,(57)(58)(59)61,62,66,67,70,(73)(74)(75)(76)(77)79,83,87,88,91,92,96,97,99,140,152,153,155,157,159,161,163,164,(166)(167)(168)(170)(171)…”

Section: Oab Symptomsmentioning

confidence: 99%

Safety considerations for synthetic sling surgery

et al. 2015

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Implantation of a synthetic midurethral sling (SMUS) is the most commonly performed anti-incontinence operation in women worldwide. The effectiveness of the SMUS is comparable to that of the historical gold standards--autologous fascial slings and the Burch colposuspension. Much controversy, however, has evolved regarding the safety of this type of sling. Overall, the quality of the studies with respect to assessing risks of SMUS-associated complications is currently poor. The most common risks in patients with SMUS include urethral obstruction requiring surgery (2.3% of patients with SMUS), vaginal, bladder and/or urethral erosion requiring surgery (1.8%) and refractory chronic pain (4.1%); these data likely represent the minimum risks. In addition, the failure rate of SMUS implantation surgery is probably at least 5% in patients with stress urinary incontinence (SUI). Furthermore, at least one-third of patients undergoing sling excision surgery develop recurrent SUI. Considering the additional risks of refractory overactive bladder, fistulas and bowel perforations, among others, the overall risk of a negative outcome after SMUS implantation surgery is ≥15%.

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Surgical Therapeutic Index of Tension-Free Vaginal Tape and Transobturator Tape for Stress Urinary Incontinence

Cited by 9 publications

References 37 publications

TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence

TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence

Baseline Urodynamic Predictors of Treatment Failure 1 Year After Mid Urethral Sling Surgery

Safety considerations for synthetic sling surgery

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