Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis

Maggiore, Umberto Leone Roberti; Agrò, Enrico Finazzi; Soligo, Marco; Marzi, Vincenzo Li; Digesu, Alex; Serati, Maurizio

doi:10.1007/s00192-017-3275-x

Cited by 76 publications

(56 citation statements)

References 30 publications

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“…In a meta‐analysis published in 2017, it was shown that both techniques of sling implantation – retropubic and transobturator – are similarly effective. Objective and subjective cumulative cure rates for TVT and TOT were 61.6% (95% CI 58.5–64.8) and 76.5% (95% CI 73.8–79.2), and 64.4% (95% CI 61.4–67.4) and 81.3% (95% CI 78.9–83.7), respectively …”

Section: Discussionmentioning

confidence: 98%

“…Objective and subjective cumulative cure rates for TVT and TOT were 61.6% (95% CI 58.5-64.8) and 76.5% (95% CI 73.8-79.2), and 64.4% (95% CI 61.4-67.4) and 81.3% (95% CI 78.9-83.7), respectively. 16 The authors of a Cochrane analysis showed that there is evidence that at up to 1-year observation the rate of subjective cure of TOT and TVT is high and similar (RR 0.98, 95% CI 0.96, 1.00; 36 trials, 5514 women; moderate quality evidence) ranging from 62% to 98% in the TOT group, and from 71% to 97% in the TVT group. 17 Nevertheless, certain patients suffer from recurrent or persistent SUI after the surgery.…”

Section: Discussionmentioning

confidence: 99%

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Does the suburethral sling change its location?

et al. 2017

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Does the suburethral sling change its location?

et al. 2017

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“…In SISTer trial, Albo et al [21] reported the objective cure rates for PVS and BC at the second year as 66% and 49%, respectively. In another study, Maggiori et al [23] reported lower objective cure rates in the fifth year, with 30% for PVS and 24% for BC and reported that the majority of the study population probably consisted of the incontinent participants of the previous study. In the present study, objective cure rate was calculated as 100% based on the one-hour pad test and cough stress test results.…”

Section: Discussionmentioning

confidence: 93%

Modified autologous transobturator tape surgery — evaluation of short term results

et al. 2020

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Objectives: The aim of this study is to evaluate the short-term outcomes of our modified autologous transobturator tape (aTOT) technique with rectus abdominis muscle fascial graft for the treatment of female stress urinary incontinence (SUI). Material and methods: The data of 22 patients who underwent modified aTOT were recorded. Perioperative data regarding operative time, complications and postoperative visual analogue scores were noted. Patients were assessed 18 months after surgery. The primary endpoints of this study were the improvements in the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) subscores, one-hour pad test and cough stress test rates as an objective cure as well as the improvements in the PGI-I and ICIQ-FLUTS quality of life scores as a subjective cure. Results: Mean age and the mean follow-up period were 51.7 ± 9.8 years and 20.1 ± 0.9 months, respectively. Urethral hypermobility and a positive cough stress test were detected in all the patients. Mean operative time was 43.8 ± 8.1 min. and the overall complication rate was 9%. Mean VAS scores at postoperative 24 hours were 2.6 ± 1.2. At the postoperative eighteenth month, no patient had a positive cough test and mean PGI-I score was 2 while two patients had moderate urinary incontinence according to the pad test. Pad test results, ICIQ subscores of voiding QoL, incontinence, incontinence QoL, total score and total QoL score at baseline and eighteen months after surgery were 76.

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“…Results of 17 years follow-up report that over 90% of women were objectively continent and 87% were subjectively cured or improved significantly [8]. Recently, some published studies and meta-analysis have suggested that mid-term results of TVT and TOT maybe quite similar [17,27]. Complications after TVT and TVTO have led to the introduction of first SIMS -the TVT Secur™.…”

Section: Discussionmentioning

confidence: 99%

“…journals.viamedica.pl/ginekologia_polska between TVT and TOT, which led to modifications of TOT implantation technique so to optimize the results [12,13]. Yet, after TOT implantation some other complications were observed such as thigh and groin pain, which usually has a very negative impact on patient's quality of life [16,17]. To avoid such complications a single-incision-mini-sling (SIMS) TVT-Secur™ was introduced but poor midterm results have led to cessation of this product by the company [18].…”

Section: Introductionmentioning

confidence: 99%

Adjustable single incision sling Ajust — the effects of first operations controlled by pelvic floor sonography

Kluz¹,

Wlaźlak²,

Wróbel³

et al. 2017

Ginekol Pol

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Objective: The aim of this study is to evaluate using PFS-TV the mid-term results of our first operative experience with implanting a single incision sling -Ajust™. Material and methods:One and the same surgeon has operated all the patients with symptoms of stress urinary incontinence. Ajust was the only performed procedure. Postoperative evaluation consisted of: a standardized interview and examination, a cough test and a PFS-TV for evaluation of urinary continence and tape location. PFS-TV was performed under standardized conditions at rest and during maximum Valsalva maneuver.Results: This is a retrospective analysis of data from a total of 31 patients who attended a control visit between the 36 th and the 50 th month following the operation. Sixteen patients (51.6%) were cured. There were statistically significant differences in urethral mobility (p < 0.0007) and tape-urethra distance (p < 0.002) between cured and not-cured group. The difference in urethral length was not statistically significant. 77.8% of women with a hypermobile urethra was cured in contrast to 15.4% with a normobile urethra. Neither of the groups had a hypomobile urethra patient. There were no significant complications intra-or post-operatively. De novo urgency was observed in 1 patient only.Conclusions: Implantation of Ajust tape seems to be a safe mode of operative treatment for SUI in women. Our mid-term results suggest that long term effects might be worse compared to retropubic or transobturator tapes, especially at first operative experience with Ajust. Urethral mobility seems to be an important risk factor for treatment failure after Ajust implantation. It seems that patients that may benefit from Ajust most are women with urethral hypomobility but this needs to be verified with a prospective study.

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Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis

Abstract: Independent of the technique adopted, findings from this systematic review and meta-analysis suggest that the treatment of SUI with MUS might be similarly effective and safe at long-term follow-up.

Cited by 76 publications

References 30 publications

Does the suburethral sling change its location?

Does the suburethral sling change its location?

Modified autologous transobturator tape surgery — evaluation of short term results

Adjustable single incision sling Ajust — the effects of first operations controlled by pelvic floor sonography

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