Dali Cheng1, Caigang Liu. 1. Department of Gynecology and Obstetrics, Shengjing Hospital, China Medical University, Shenyang, China. chengdalishengjing@163.com
Abstract
OBJECTIVES: To evaluate the medium-term outcomes of using tension-free vaginal tape-obturator (TVT-O) in the treatment of patients with stress urinary incontinence (SUI). STUDY DESIGN: Between December 2004 and November 2005, 103 patients with SUI were enroled and treated with TVT-O with inside-out modification. A minimum five-year follow-up (median, 65 months) was obtained from 100 patients (99.6%). Preoperative and postoperative evaluations were performed for all patients. The objective success rate of the TVT-O procedure was evaluated by a negative stress test. The secondary outcomes measured included one- and five-year subjective success rates, together with the pre- and post-operative urodynamic parameters, complications, quality of life (QOL) analysis, and patient satisfaction. RESULTS: Among the 103 patients, 18 (17.4%) had postoperative voiding difficulties and needed urethral bladder catheterization for various periods. After the TVT-O procedure, complete disappearance of SUI occurred in 87.4% of patients, while improvement was found in about 92%. In addition, there was no difference in the cure rate between year 1 and year 5 after the procedure (P>0.05). In 90 patients, frequency and urge symptoms were significantly improved five years after the procedure (P<0.005), and maximal flow rates were decreased (P<0.05). However, the severity of obstructive symptoms and postvoid residual volumes at five years were not improved compared with one year after the procedure (P=0.10 and P=0.33 respectively). Finally, compared to pre-operation, incontinence severity degree and QOL scale scores were largely improved after the operation (P<0.001), while no difference was found between years 1 and 5 (P=0.11and P=0.09 respectively). CONCLUSIONS: Our result shows that the TVT-obturator, a novel mid-urethral sling, is a safe and effective procedure for the treatment of female SUI. Medium-term therapeutic results appear promising but further evaluation of long-term therapeutic outcomes is needed.
OBJECTIVES: To evaluate the medium-term outcomes of using tension-free vaginal tape-obturator (TVT-O) in the treatment of patients with stress urinary incontinence (SUI). STUDY DESIGN: Between December 2004 and November 2005, 103 patients with SUI were enroled and treated with TVT-O with inside-out modification. A minimum five-year follow-up (median, 65 months) was obtained from 100 patients (99.6%). Preoperative and postoperative evaluations were performed for all patients. The objective success rate of the TVT-O procedure was evaluated by a negative stress test. The secondary outcomes measured included one- and five-year subjective success rates, together with the pre- and post-operative urodynamic parameters, complications, quality of life (QOL) analysis, and patient satisfaction. RESULTS: Among the 103 patients, 18 (17.4%) had postoperative voiding difficulties and needed urethral bladder catheterization for various periods. After the TVT-O procedure, complete disappearance of SUI occurred in 87.4% of patients, while improvement was found in about 92%. In addition, there was no difference in the cure rate between year 1 and year 5 after the procedure (P>0.05). In 90 patients, frequency and urge symptoms were significantly improved five years after the procedure (P<0.005), and maximal flow rates were decreased (P<0.05). However, the severity of obstructive symptoms and postvoid residual volumes at five years were not improved compared with one year after the procedure (P=0.10 and P=0.33 respectively). Finally, compared to pre-operation, incontinence severity degree and QOL scale scores were largely improved after the operation (P<0.001), while no difference was found between years 1 and 5 (P=0.11and P=0.09 respectively). CONCLUSIONS: Our result shows that the TVT-obturator, a novel mid-urethral sling, is a safe and effective procedure for the treatment of female SUI. Medium-term therapeutic results appear promising but further evaluation of long-term therapeutic outcomes is needed.
Authors: Giovanni A Tommaselli; Costantino Di Carlo; Carmen Formisano; Annamaria Fabozzi; Carmine Nappi Journal: Int Urogynecol J Date: 2015-05-20 Impact factor: 2.894
Authors: Jerry G Blaivas; Rajveer S Purohit; Matthew S Benedon; Gabriel Mekel; Michael Stern; Mubashir Billah; Kola Olugbade; Robert Bendavid; Vladimir Iakovlev Journal: Nat Rev Urol Date: 2015-08-18 Impact factor: 14.432