Surgeon’s experience and clinical outcome after retropubic tension‐free vaginal tape—A case series

Holdø, Bjørn; Møllersen, Kajsa; Verelst, Margareta; Milsom, Ian; Svenningsen, Rune; Skjeldestad, Finn Egil

doi:10.1111/aogs.13830

Cited by 7 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This might be due to the high level of expertise of the surgeons who operated on our sample. Holdø et al showed an increasing rate of bladder perforations and urinary retentions among patients whose TVT procedures were performed by "beginners" [ 11 ]. In contrast to their study, two certified pelvic organ prolapse surgeons undertook or supervised the procedures in this study.…”

Section: Discussionmentioning

confidence: 99%

The Transobturator Tape Versus Retropubic Tension-Free Vaginal Tape in the Treatment of Comorbid and Elderly Women With Stress Urinary Incontinence: A Retrospective Analysis of Over 800 Women

Schütze¹,

Behre²,

Heitmeir³

et al. 2023

Cureus

View full text Add to dashboard Cite

Background and objectiveThe first-line surgical treatment for female stress urinary incontinence (SUI) involves midurethral slings (MUS), including the transobturator tape (TOT) and the retropubic tension-free vaginal tape (TVT). However, whether offering these procedures to older and comorbid women could lead to increased complications is a question that needs to be seriously addressed. In this retrospective cohort study, we aimed to compare the two procedures and evaluate the impact of age, BMI, and comorbidities on complications. Materials and methodsA total of 873 procedures (306 TVTs/567 TOTs) performed between 2007 and 2017 were compared and correlated with regard to age, BMI, and comorbidities. Intraoperative complications included bleeding >50 ml, bladder injury, and anesthesia-associated complications. Postoperative complications included postvoid residual volume, pain, hematoma, lower urinary tract infection, revision for loosening tape, and bladder infections. The comorbidities were evaluated based on the American Society of Anesthesiologists (ASA) and Charlson scores. ResultsA total of 873 MUS were conducted during the study period: 306 TVTs and 567 TOTs. Groupwise comparison between these procedures showed that women in the TOT group were older (p<0.001) with a higher BMI (p<0.001) and a higher ASA score (p<0.001) compared to the TVT group. Nevertheless, significantly more intraoperative complications, especially bladder injuries, were recorded in the TVT group. Postoperative complications occurred in 19.4% of the entire cohort, especially increased post-void residual volume. Postoperative hematoma and tape loosening were significantly more frequent in the TOT group. Age, BMI, and comorbidities showed no significant impact on intraoperative complications; however, the TOT procedure was associated with significantly fewer intraoperative complications [p=0.001, odds ratio (OR): 0.281]. ConclusionsOverall, both procedures were associated with a low number of perioperative complications. The TOT technique had a lower incidence of intraoperative complications. It must be highlighted that age and comorbidities had no influence on either the intra-or postoperative complication rates. Hence, we recommend that TOT is employed to treat SUI in older, more obese, and comorbid women.

show abstract

Section: Discussionmentioning

confidence: 99%

The Transobturator Tape Versus Retropubic Tension-Free Vaginal Tape in the Treatment of Comorbid and Elderly Women With Stress Urinary Incontinence: A Retrospective Analysis of Over 800 Women

Schütze¹,

Behre²,

Heitmeir³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Only three surgeons at a time have been performing the MUS procedure in our department. In this way, the volume has been kept high for the surgeons, which has previously been shown to reduce complications [ 18 , 19 ]. Over time, we have employed the same procedure to treat POUR and vaginal sling exposures [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Impact on urinary incontinence after management of complications related to a retropubic midurethral sling

Juhl,

Thimm,

Glavind

2023

Int Urogynecol J

View full text Add to dashboard Cite

Introduction and hypothesis The most common complications to midurethral sling (MUS) operations for stress urinary incontinence are postoperative urinary retention (POUR), vaginal MUS exposure, and urgency. They are well described but consensus regarding their management is missing. An evaluation of the treatment of POUR, exposure and urgency after the MUS procedure in our department was implemented. Incontinence status after treatment of complications was evaluated. Methods A review of the medical records of women undergoing MUS procedures from 1 January 2017 to 31 December 2021 (n = 329). Results A total of 279 women (85%) had no complications. Fifty women had one or more complications. Twenty-three women (7%) experienced POUR. Final treatment in 9 women was clean intermittent self-catheterization (CISC). All remained continent. Nine women had the MUS mobilized. This was successful in 8 women who remained continent. Six women had their MUS incised (one after unsuccessful mobilization). Four became incontinent again and 2 remained continent. Eight women had vaginal MUS exposure. Seven attempted recovering of the MUS. This was successful in 3 patients. The remaining had a partial MUS removal. Only 33% remained continent after removal. Ten patients developed de novo urge, but only 2 needed medication. Conclusions Mobilization of the MUS must be considered the optimal treatment for POUR when CISC fails. It is the most effective intervention with the best effect on POUR and the lowest risk of incontinence. Concerning vaginal exposure, a trial of recovering should be attempted as the risk of incontinence when undergoing a partial removal of the MUS is considerable.

show abstract

“…The target perforation rate of 5% was reached between 20 and 80 operations. In 2020, Holdø et al 15 showed a lower rate of bladder perforations and urinary retentions among patients whose TVT procedures were performed by surgeons with experience of ≥50 primary TVT procedures.…”

Section: Discussionmentioning

confidence: 99%

“…There is no published systematic review for the learning curve of tension‐free vaginal tape (TVT). A PubMed search in August 2020, search mesh: ([“TVT” or “tension free vaginal tape”] and [“learning curve” or “learning curves”]), resulted in 28 papers, only five papers of which were deemed suitable for an analysis of a TVT learning curve (one database‐derived, three institutional and one single‐surgeon study) 11‐15 . The occurrence of intraoperative bladder perforations was significantly increased in all learning groups (as high as 40%) and the duration of the learning process was up to 80 cases.…”

Section: Introductionmentioning

confidence: 99%

The tension‐free vaginal tape operation: Is the inexperienced surgeon a risk factor? Learning curve and Swedish quality reference

Nüssler

Löfgren

Lindkvist

et al. 2020

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

Surgeon’s experience and clinical outcome after retropubic tension‐free vaginal tape—A case series

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 7 publications

References 25 publications

The Transobturator Tape Versus Retropubic Tension-Free Vaginal Tape in the Treatment of Comorbid and Elderly Women With Stress Urinary Incontinence: A Retrospective Analysis of Over 800 Women

The Transobturator Tape Versus Retropubic Tension-Free Vaginal Tape in the Treatment of Comorbid and Elderly Women With Stress Urinary Incontinence: A Retrospective Analysis of Over 800 Women

Impact on urinary incontinence after management of complications related to a retropubic midurethral sling

The tension‐free vaginal tape operation: Is the inexperienced surgeon a risk factor? Learning curve and Swedish quality reference

Contact Info

Product

Resources

About