Tension-Free Vaginal Tape (TVT) in Stress Incontinent Women with Intrinsic Sphincter Deficiency (ISD)  A Long-Term Follow-up

Rezapour, Masoumeh; Falconer, Christian; Ulmsten, Ulf

doi:10.1007/s001920170005

Cited by 246 publications

(163 citation statements)

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“…For patients with recurrent incontinence, the results are similar to those achieved with a primary procedure; for those with a fixed urethrovesical junction, the outcome is poor, as it is with any other surgical procedures [41][42][43]. Holmgren conducted a long-term study, published in 2005, concluding that initial cure rates of TVT were good for mixed incontinence but did not persist after four years [44].…”

Section: Pre-pubic Tvt Proceduresmentioning

confidence: 85%

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Tension-Free Mini-Invasive Anti-Incontinence Procedures: Comparison Among Three Main Pathways

Leanza¹

2012

TOWHJ

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Abstract:Objective. To evaluate both results and complications of Retro-pubic, Pre-pubic and Trans-obturator miniinvasive anti-incontinence surgical procedures.Material and methods. Search of PubMed, Cochrane library and relevant articles from 1996 to 2012.Results. Seventy-four works were found. Literature showed similar cure rates among retro-pubic (71,4-91%), transobturator (77,3-95%) and pre-pubic (81-87,2%) anti-incontinence procedures. Cystoscopy is considered as necessary in the retro-pubic, optional in the trans-obturator, unnecessary in the pre-pubic procedure. Intra-operative cough stress test is believed to be useful only when using the retro-pubic and the pre-pubic path. Obstruction symptoms prevail in the retropubic, are rare in the trans-obturator and not recorded in the pre-pubic procedure. The erosion rate is similar for the all the three techniques. Permanent catheterization is found in 3% of the retro-pubic technique group. The retro-pubic path may be mainly performed for the cure of recurrent stress incontinence (RSI) and intrinsic sphincter deficiency (ISD) in absence of obstructive symptoms. Due to the danger involved in the retro-pubic space, intra-operative vascular and perforating risks prevail in the retro-pubic procedure, whereas the onset of late infective complications in the trans-obturator technique is due to the site of the mesh tip that may interfere with the movements of the thigh. No severe complications were reported in the pre-pubic procedure. Conclusion.In the severe cases of SUI, RSI and in ISD the retro-pubic tension-free route remains the favourite; when obstructive symptoms prevail, the prepubic technique is the most appropriate; whereas for all other cases, the trans-obturator procedure is the most suitable.

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Section: Pre-pubic Tvt Proceduresmentioning

confidence: 85%

“…A number of prospective observational trials have been conducted to evaluate the effectiveness of the TVT procedure [34][35][36][37][38][39].…”

Section: Pre-pubic Tvt Proceduresmentioning

confidence: 99%

Tension-Free Mini-Invasive Anti-Incontinence Procedures: Comparison Among Three Main Pathways

Leanza¹

2012

TOWHJ

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“…Midüretral sling operasyonlarının öğrenme eşiği ile ilgili literatürde net veri yoktur. Bizim hastanemiz ürojinekoloji bölümün-de, asistan vaka sayıları homojen olmadığı ve muhtemelen öğ-renme eşiği altında kaldığı halde majör komplikasyon oranları benzerlik göstermektedir [15,16]. Öte yandan, bilimsel camiada komplikasyonları bildirmeme eğilimi de, bizim minör komplikasyon oranlarımızın yüksek görünmesine sebep olmuş olabilir.…”

Section: Gereç Ve Yöntemunclassified

“…Bu nedenle ,literatüre katkı sağlaması amacıyla, kendi kliniğimizde asistanların uzman eşliğinde yaptığı midüret-ral slingleri komplikasyon ve tedavi oranları açısından inceledik. Midüretral sling operasyonlarında kanama insidansı tanıma bağlı değişmekle birlikte, TVT sonrası %0.7-8 arasında [14,15], TOT sonrası ise %0-2 arasında bildirilmiştir [16,17].Bizim çalış-mamızda, 91 TVT yapılan hastanın 3(%3.3) ünde transfüzyon gerektiren kanama izlenirken, 50 TOT yapılan hiçbir hastada transfüzyon gerektiren kanama izlenmedi. TVT yapılan ve transfüzyon gerektiren 3 hastadan birinde, postoperatif 4.saatte kanama nedeniyle laparotomi yapıldı.…”

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Effect of Resident Performance on Midurethral Sling Cure and Complication Rates

Cavkaytar¹,

Kokanali²,

Iskender³

et al. 2015

Ann Clin Anal Med

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ÖzetAmaç: Asistanların uzman eşliğinde yaptığı midüretral slingleri komplikasyon ve tedavi oranları açısından incelemek. Gereç ve Yöntem: Ocak 2013 ve Ocak 2014 tarihleri arasında Ankara Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Ürojinekoloji Kliniği'nde yapılan üriner stres inkontinans nedeni ile yapılan 141 midüretral sling ameliyatı değerlendirmeye alın-dı. Hastaların yaşı, parite, vücut kitle indeksi, menopoz durumu, preoperatif >2.derece POP varlığı, eşlik eden vajinal cerrahi gibi özellikleri ile intraoperatif (mesane ve bağırsak zedelenmesi, kanama, vajinal laserasyon ) ve erken postoperatif (idrar retansiyonu vb) komplikasyonlar kaydedildi. Postoperatif 6. ayda, bütün hastalar tekrar muayene edildi ve semptomlar konusunda sorgulandı. Stres testi negatif olup düzeldiğini belirtenler ''iyileşmiş'', inkontinans sıklığı azalmakla beraber halen devam edenler '' kısmi iyileşmiş'' ve inkontinans şikayetlerinde değişiklik olmayanlar '' başarısız'' olarak sınıflan-dırıldı. Hem TVT , hem de TOT grubu komplikasyonlar ve tedavi oranları açı-sından karşılaştırıldı. Bulgular: Saf stres üriner inkontinans nedeniyle midü-retral sling operasyonu uygulanan 141 hastadan, 50(%35.5) tanesinde TOT, 91(%64.5) tanesinde ise TVT uygulandı. TVT grubunda 3 (%3.3) hastada kan transfüzyonu gerektiren postoperatif kanama ve 5 (%5.5) hastada mesane perforasyonu izlendi. Buna karşın TOT grubundaki hastalarda postoperatif ciddi kanama ve mesane perforasyonu gözlenmedi. Postoperatif erken dö-nemde TOT operasyonu sonrası 7 (%14.0) hastada, TVT operasyonu sonrası ise 17 (18.7) hastada üriner retansiyon gelişti. TOT ve TVT uygulanan hastalar, intraoperatif ve postoperatif erken komplikasyonların sıklığı bakımın-dan istatistiksel olarak benzerdi. Postoperatif 6. ayda TOT uygulanan hastaların % 76 sı iyileşmiş, % 18 i kısmi iyileşmiş iken % 6sında operasyon başarısız iken, TVT uygulanan hastalar için bu sonuçlar sırası ile % 83.5, %12.1 ve %4.4 idi ve istatistiksel olarak fark yoktu. Tartışma: Asistanların tecrübeli cerrahların gözetiminde yaptığı midüretral slinglerin başarı ve majör komplikasyon oranları literatürle uyumludur. Minör komplikasyon oranları biraz yük-sek gözükse de, tedavi başarısı ve hasta memnuniyetini etkilememektedir. Anahtar KelimelerÜriner İnkontinans; Midüretral Sling; Asistan; Komplikasyon Abstract Aim: To evaluate the cure rates and complications of midurethral slings performed by residents under an experienced surgeon supervision. Material and Method: Between January 2013 and January 2014, one hundred forty-one midurethral slings performed in the urogynecology clinic of Ankara Zekai Tahir Burak Women's Health Research and Education Hospital were reviewed.Age, parity,body mass index,menopausal status, grade 2 preoperative pelvic organ prolapsus,concomitant vaginal surgery and intraoperative (bladder and bowel perforations,bleeding,vaginal laceration) and early postoperative (urinary retention etc.)complications were recorded.All women were re-examined at postoperative 6 th month and symptoms were q...

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“…This study was published in 1998 [9], but the results were available to the investigators at the beginning of the year before. The results of trials with a followup of 4 years on women suffering from recurrent stress incontinence, intrinsic sphincter deficiency, and mixed urinary incontinence were published in 2001, once again with excellent cure rates [10][11][12]. Already in the year 2000 5-year follow-up results were available and published in June 2001 showing an overall cure rate of 85 % according to the abovementioned criteria [13] ( Table 1).…”

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confidence: 99%

Creating a gold standard surgical procedure: the development and implementation of TVT

Nilsson

2015

Int Urogynecol J

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The last two decades have witnessed a launch of new surgical procedures, utilizing kits and synthetic materials, at a pace not formerly seen. Some launches have been preceded by thorough clinical documentation and others not. Any innovation, be it a theory or a treatment concept, is only fantasy until it has been tested and clinically documented.Within the field of surgical management of female stress urinary incontinence the presentation of the mid-urethral theory (a part of the integral theory [1]) implied a paradigm shift of understanding the mechanism of stress incontinence. The theory relied on discoveries and ideas presented between the 1950s and the 1980s by several clinicians such as Axel Ingelman-Sundberg [2], Robert F. Zacharin [3,4], and Ulf Ulmsten [5][6][7] just to mention a few. The theory was put into practice by a team led by Professor Ulf Ulmsten by developing a new minimally invasive, ambulatory, standardized surgical procedure to be named the tension-free vaginal tape (TVT) at the time of launch in Europe at the end of 1997 and in the USA at the end of 1998.Several modifications of a procedure were tested before arriving at the final one, which included the use of a monofilament polypropylene tape with a mesh structure and a pore size of> 75 μm. Once the procedure was finalized, the first prospective clinical trial was conducted at the Department of Obstetrics and Gynecology of the University Hospital of Uppsala, Sweden, the chairman of which was Professor Ulmsten. The trial included 75 primary cases of stress urinary incontinence and were followed for 24 months. The results published in 1996 were very encouraging [8] and prompted further prospective clinical trials conducted in normal clinical settings. At this stage it was decided to follow the same study protocol in all the trials to come.The pre-and postoperative evaluations were to include urodynamic testing, a cough stress test, a 24-h pad weighing test, a 2-day voiding diary, residual urine measurement, urine analysis, pelvic examination, and as a quality of life measure a visual analog scale (VAS) on the bother caused by urinary symptoms. It was also decided on the criteria of cure and improvement. To be regarded cured a patient should have a negative stress test and negative pad test, be continent in postoperative urodynamics, and score less than 10 on the VAS, where 0 represents no urinary problems whatsoever and 100 unbearable urinary symptoms. Improvement required a negative stress test, a significant reduction of leakage on the 24-h pad test, and a≥70 % improvement of the individual VAS score. All other cases were regarded as failures.A multicenter trial including six clinics in Finland and Sweden enrolled 130 primary cases of stress incontinence, who were followed for a minimum of 12 months, showed the same high rate of success as the initial trial. This study was published in 1998 [9], but the results were available to the investigators at the beginning of the year before. The results of trials with a followup of 4 years on wome...

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Tension-Free Vaginal Tape (TVT) in Stress Incontinent Women with Intrinsic Sphincter Deficiency (ISD) A Long-Term Follow-up

Cited by 246 publications

References 10 publications

Tension-Free Mini-Invasive Anti-Incontinence Procedures: Comparison Among Three Main Pathways

Tension-Free Mini-Invasive Anti-Incontinence Procedures: Comparison Among Three Main Pathways

Effect of Resident Performance on Midurethral Sling Cure and Complication Rates

Creating a gold standard surgical procedure: the development and implementation of TVT

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Tension-Free Vaginal Tape (TVT) in Stress Incontinent Women with Intrinsic Sphincter Deficiency (ISD)  A Long-Term Follow-up

Cited by 246 publications

References 10 publications

Tension-Free Mini-Invasive Anti-Incontinence Procedures: Comparison Among Three Main Pathways

Tension-Free Mini-Invasive Anti-Incontinence Procedures: Comparison Among Three Main Pathways

Effect of Resident Performance on Midurethral Sling Cure and Complication Rates

Creating a gold standard surgical procedure: the development and implementation of TVT

Contact Info

Product

Resources

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Tension-Free Vaginal Tape (TVT) in Stress Incontinent Women with Intrinsic Sphincter Deficiency (ISD) A Long-Term Follow-up