Juan Gambini-Ricapa1, Javier García-Oms1, Miguel Barea1, Angeles Estrada1, Alejandra Iturri1, Juan Gambini-Buchon2, Juan Gilabert-Estelles3,4. 1. Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain. 2. Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain. 3. Unidad de Endoscopia y Oncología Ginecológica, Hospital General Universitario de Valencia, Av. Tres Cruces 2, 46014, Valencia, Spain. gilabert_juaest@gva.es. 4. Departamento de Pediatria, Obstetricia y Ginecología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain. gilabert_juaest@gva.es.
Abstract
INTRODUCTION AND HYPOTHESIS: We present our 10-year experience in treating stress urinary incontinence (SUI) using a new minisling technique based on a tension-free vaginal tape band designed by our group. The major advantage of this tape is the use of minibelt polypropylene inserted through a single retropubic incision without the use of needles-the Endopelvic Free Anchor (EFA)-based on its location at the midurethra with a U shape. For insertion, each branch is placed using a simple Pean clamp from the vagina with perforation of the endopelvic fascia to achieve a retropubic insertion. METHODS: From May 2001 to May 2011, we surgically treated 166 women with primary first- or second-degree SUI due to urethral hypermobility without genital prolapse. All were evaluated according to our study protocol, which included clinical and urodynamic evaluation before and 12 months after surgery. RESULTS: With a median follow-up of 5 (1-11) years, 152 patients (91.6 %) were fully cured both from urodynamic and subjective points of view. Six patients (3.6 %) had significant improvement, and eight (4.8 %) were identified as technique failure. Complications included one bladder perforation (0.6 %), two cases of postoperative urinary retention (1.24 %), two of retropubic hematoma (1.24 %), and one of de novo urgency (0.6 %). No reinterventions were necessary, and there were no major bleeding complications, no chronic pain or de novo dyspareunia, and no voiding difficulty. CONCLUSIONS: EFA is a viable, safe, and effective technique for treating UI due to urethral hypermobility.
INTRODUCTION AND HYPOTHESIS: We present our 10-year experience in treating stress urinary incontinence (SUI) using a new minisling technique based on a tension-free vaginal tape band designed by our group. The major advantage of this tape is the use of minibelt polypropylene inserted through a single retropubic incision without the use of needles-the Endopelvic Free Anchor (EFA)-based on its location at the midurethra with a U shape. For insertion, each branch is placed using a simple Pean clamp from the vagina with perforation of the endopelvic fascia to achieve a retropubic insertion. METHODS: From May 2001 to May 2011, we surgically treated 166 women with primary first- or second-degree SUI due to urethral hypermobility without genital prolapse. All were evaluated according to our study protocol, which included clinical and urodynamic evaluation before and 12 months after surgery. RESULTS: With a median follow-up of 5 (1-11) years, 152 patients (91.6 %) were fully cured both from urodynamic and subjective points of view. Six patients (3.6 %) had significant improvement, and eight (4.8 %) were identified as technique failure. Complications included one bladder perforation (0.6 %), two cases of postoperative urinary retention (1.24 %), two of retropubic hematoma (1.24 %), and one of de novo urgency (0.6 %). No reinterventions were necessary, and there were no major bleeding complications, no chronic pain or de novo dyspareunia, and no voiding difficulty. CONCLUSIONS:EFA is a viable, safe, and effective technique for treating UI due to urethral hypermobility.
Authors: Maria Andrada Hamer; Per-Göran Larsson; Pia Teleman; Christina Eten Bergqvist; Jan Persson Journal: Int Urogynecol J Date: 2012-06-16 Impact factor: 2.894
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Authors: Matej Keršič; Maruša Keršič; Tina Kunič; Simone Garzon; Antonio Simone Laganà; Matija Barbič; Adolf Lukanović; David Lukanović Journal: Gynecol Minim Invasive Ther Date: 2020-08-01