Female Stress Urinary Incontinence

Abstract

We performed an observational longitudinal cohort study on patients affected by stress urinary incontinence (SUI) and surgically treated with a transobturator adjustable tape sling (TOA) in order to evaluate this surgical procedure in terms of efficacy, safety, quality of life (QoL) improvement, and patient satisfaction. For all patients, we recorded: general features, preoperative SUI risk factors, obstetrics history, preoperative urodynamic tests, intraoperative/postoperative complications, number of postoperative sling regulations, postmicturition residue, and hospital stay. All patients were asked to complete the validated short version of the Urogenital Distress Inventory (UDI-6) questionnaire 18 months after discharge to evaluate the efficacy of the TOA system. We added 2 adjunctive items to the UDI-6 in order to evaluate patient satisfaction and QoL. All 77 surgical procedures were performed under locoregional anesthesia without complications. Postoperative TOA regulations were performed in 46.8% of patients immediately after the procedure and in 14.3% during hospitalization. Before discharge, postmicturition residue was negative in 67 cases and less than 50 cc in 10 cases. Mean hospital stay was 2.18 days. From the questionnaire evaluation, we found that after the procedure, 90.9% of patients showed a complete regression of urinary symptoms, 1.3% obtained considerable relief from preoperative symptoms, and 6.6% reported poor or absent symptom improvements; 75.3% of patients were totally satisfied and 5.2% totally disappointed. The possibility of modulating postoperative sling tension and reusing the surgical materials in association with short hospitalization as well as high patient satisfaction render TOA a safe, effective, and low-cost technique for the treatment of female SUI.

Tunable tension tape versus transobturator tape in treatment of stress urinary incontinence in women: Randomized controlled trial

“…According to the studies, adjustment frequency ranged between 27.3% and 46.8% and short-term effectiveness was 84.4%-93.7%. 9,[13][14][15][16] It should be noted that the abovedescribed systems were used mostly in patients with more complex SUI (hypomobile urethra, Intrinsic urethral sphincter deficiency, etc.). At the same time, patients with standard SUI underwent considerable amount of adjustments as well.…”

“…As a solution to the tension problem, suburethral slings enabling an adjustment of the tension in the postoperative period were suggested (REMEEX, TVA, TOA, SAFYRE, UroSling). According to the studies, adjustment frequency ranged between 27.3% and 46.8% and short‐term effectiveness was 84.4%–93.7% 9,13–16 . It should be noted that the above‐described systems were used mostly in patients with more complex SUI (hypomobile urethra, Intrinsic urethral sphincter deficiency, etc.).…”

Midurethral synthetic tuneable tension tape in treatment of stress urinary incontinence in women.

“…Для решения «проблемы натяжения» были предложены субуретральные слинги с возможностью послеоперационной коррекции натяжения (RE-MEEX, TVA, TOA, SAFYRE, УроСлинг). Согласно исследованиям, частота регулировки натяжения этих слингов находилась в диапазоне 27,3-46,8%, а краткосрочная эффективность достигала 84,4-93,7% [9,[14][15][16][17][18]. Важно отметить, что вышеописанные системы в большинстве своем использовались для осложненных пациентов (гипомобильная уретра, сфинктерная недостаточность и т.д.).…”