Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery
Objective: A midurethral sling is the gold standard surgical treatment for stress urinary incontinence (SUI), however a lower success rate has been reported in the treatment of SUI after pelvic organ prolapse surgery. The aim of this study was to compare the success rates, quality of life, and compl...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-08-01
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| Series: | Taiwanese Journal of Obstetrics & Gynecology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1028455918301268 |
| _version_ | 1811254415754002432 |
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| author | Lim Lin Ming-Chao Huang Tsung-Hsien Su Hui-Hsuan Lau |
| author_facet | Lim Lin Ming-Chao Huang Tsung-Hsien Su Hui-Hsuan Lau |
| author_sort | Lim Lin |
| collection | DOAJ |
| description | Objective: A midurethral sling is the gold standard surgical treatment for stress urinary incontinence (SUI), however a lower success rate has been reported in the treatment of SUI after pelvic organ prolapse surgery. The aim of this study was to compare the success rates, quality of life, and complications with treatment using tension-free vaginal tape (TVT) and transobturator tape (TOT) in these patients. Materials and Methods: We enrolled patients who had symptomatic SUI after anterior vaginal mesh repair who underwent either TVT or TOT surgery. Successfully cure was defined as the absence of urinary leakage in a stress test during filling cystometry, and a negative cough test. Quality of life was evaluated using the short form of the Urinary Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). Results: We included 50 patients in the TOT group and 37 patients in the TVT group, with a median follow-up of 18.5 months. The TVT group had a significantly higher success rate than the TOT group (88% vs. 60%, p = 0.036), while there was no statistically significant difference in de novo detrusor overactivity (30% vs. 9%, p = 0.090). There was also no significant difference in postoperative quality of life (UDI-6, 5.9 ± 7.9 vs. 5.0 ± 5.9, p = 0.639; IIQ-7, 5.2 ± 12.5 vs. 4.3 ± 9.7, p = 0.766). The TVT group had a longer operative time (p < 0.001) and hospital stay (p = 0.004), however the TOT group required more repeat surgeries for recurrent SUI (p = 0.045). Conclusion: Retropubic TVT is a more effective surgical option than TOT in women with SUI after vaginal mesh repair. Keywords: Complications, Stress urinary incontinence, Transobturator sling, Retropubic sling, Quality of life |
| first_indexed | 2024-04-12T17:07:07Z |
| format | Article |
| id | doaj.art-375a6eafa5a84d1db7f33a73b6407fdc |
| institution | Directory Open Access Journal |
| issn | 1028-4559 |
| language | English |
| last_indexed | 2024-04-12T17:07:07Z |
| publishDate | 2018-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Taiwanese Journal of Obstetrics & Gynecology |
| spelling | doaj.art-375a6eafa5a84d1db7f33a73b6407fdc2022-12-22T03:23:54ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592018-08-01574528531Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgeryLim Lin0Ming-Chao Huang1Tsung-Hsien Su2Hui-Hsuan Lau3Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan; Mackay Medical College, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan; Mackay Medical College, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan; Corresponding author. #92, Chung-Shan North Road, Section 2, Taipei 104, Taiwan. Fax: +886 2 2754 3769.Objective: A midurethral sling is the gold standard surgical treatment for stress urinary incontinence (SUI), however a lower success rate has been reported in the treatment of SUI after pelvic organ prolapse surgery. The aim of this study was to compare the success rates, quality of life, and complications with treatment using tension-free vaginal tape (TVT) and transobturator tape (TOT) in these patients. Materials and Methods: We enrolled patients who had symptomatic SUI after anterior vaginal mesh repair who underwent either TVT or TOT surgery. Successfully cure was defined as the absence of urinary leakage in a stress test during filling cystometry, and a negative cough test. Quality of life was evaluated using the short form of the Urinary Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). Results: We included 50 patients in the TOT group and 37 patients in the TVT group, with a median follow-up of 18.5 months. The TVT group had a significantly higher success rate than the TOT group (88% vs. 60%, p = 0.036), while there was no statistically significant difference in de novo detrusor overactivity (30% vs. 9%, p = 0.090). There was also no significant difference in postoperative quality of life (UDI-6, 5.9 ± 7.9 vs. 5.0 ± 5.9, p = 0.639; IIQ-7, 5.2 ± 12.5 vs. 4.3 ± 9.7, p = 0.766). The TVT group had a longer operative time (p < 0.001) and hospital stay (p = 0.004), however the TOT group required more repeat surgeries for recurrent SUI (p = 0.045). Conclusion: Retropubic TVT is a more effective surgical option than TOT in women with SUI after vaginal mesh repair. Keywords: Complications, Stress urinary incontinence, Transobturator sling, Retropubic sling, Quality of lifehttp://www.sciencedirect.com/science/article/pii/S1028455918301268 |
| spellingShingle | Lim Lin Ming-Chao Huang Tsung-Hsien Su Hui-Hsuan Lau Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery Taiwanese Journal of Obstetrics & Gynecology |
| title | Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery |
| title_full | Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery |
| title_fullStr | Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery |
| title_full_unstemmed | Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery |
| title_short | Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery |
| title_sort | comparison between tension free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery |
| url | http://www.sciencedirect.com/science/article/pii/S1028455918301268 |
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