Tension-Free Vaginal Tape and Autologous Rectus Fascia Pubovaginal Sling for the Treatment of Urinary Stress Incontinence: A Medium-Term Follow-Up

Abstract

Objectives: To compare two different procedures, tension-free vaginal tape (TVT) and autologous rectus fascia sling, according to their medium-term subjective and objective outcomes and satisfaction rates in the treatment of urinary stress incontinence in women. Subjects and Methods: One hundred women with type II urinary stress incontinence were randomized to be treated with either TVT or autologous rectus fascia sling. They were evaluated by means of a cough-induced stress test, 1-hour pad test, Incontinence Impact Questionnaire (IIQ), and urodynamic study. They were reevaluated postoperatively every 6 months, and the collected data of more than 1 year’s follow-up were compared with preoperative assessments. Results: All patients completed the full 6-month postoperative assessment. However, of the 100 patients, only 61 (25 in the TVT and 36 in the sling group) were followed for more than 1 year. Mean follow-up time was 38.5 and 40 months in the TVT and sling group, respectively. Objective cure was achieved in 22 (88%) of the TVT group and in 30 (83%) of the sling group (p = 0.78) using a cough-induced stress test, and in 76 and 75% of the women in the TVT versus sling group (p = 0.83), respectively, using a 1-hour pad test. Postoperative mean IIQ scores were 44.3 (range 35.5–61.5) and 48.5 (range 38.5–69.7) in the TVT versus sling group (p = 0.46). Five (20%) and 11 (30%) of the TVT and sling group, respectively, reported some changes in the voiding pattern or posture at more than 1 year’s follow-up. Conclusion: There is no significant difference between the TVT and autologous rectus fascia sling procedures in the treatment of urinary stress incontinence at medium-term follow-up. There were changes in the voiding pattern for patients in both groups at more than 1 year postoperatively, which were not evident at early follow-up.

Modified pubovaginal sling technique in the surgical management of female stress urinary incontinence

“…This value is consistent with the literature ones, 83% to 94% 8,[14][15][16] . Table 2 -Table 2 -Table 2 -Table 2 -Table 2 Table 3 -Table 3 -Table 3 -Table 3 - Table 3 Analysis of variance with summary measures (General).…”

Mini Sling (Ophira) versus Pubovaginal Sling for Treatment of Stress Urinary Incontinence: A Medium-term Follow-up

“…The authors concluded that Ophira and TOT procedures were comparable in terms of both objective and subjective cure rates; however the major advantage of Ophira compared to TOT was the facility of performing the procedure under local anesthesia on an ambulatory basis with less postoperative pain and intraoperative complication (Smith et al, 2011). Sharifiaghdas and Mortazavi (2008) have compared tension-free vaginal tape (TVT) with rectus facia pubovaginal sling in 61 patients (25 in the TVT and 36 in the sling group). The authors concluded that TVT and pubovaginal rectus facia sling were comparable in terms of both objective and subjective cure rate (Sharifiaghdas and Mortazavi, 2008).…”

“…Sharifiaghdas and Mortazavi (2008) have compared tension-free vaginal tape (TVT) with rectus facia pubovaginal sling in 61 patients (25 in the TVT and 36 in the sling group). The authors concluded that TVT and pubovaginal rectus facia sling were comparable in terms of both objective and subjective cure rate (Sharifiaghdas and Mortazavi, 2008). Our study showed an objective cure rate of 84.2% and 88.6% in the sling and Ophira groups respectively.…”

“…SUI has a negative impact on quality of life and represents an important economic burden, as a social health problem (Gauruder-Burmester and Popken, 2009). Conservative managements such as pelvic floor muscle training, biofeedback and electrical stimulation may improve the problem, though persistence in therapy is needed (Sharifiaghdas and Mortazavi, 2008). However, for most of the women, surgery remains the basis of SUI management (Zoorob and Karram, 2012).…”

Contemporary Comparison Between Retropubic Midurethral Sling and Autologous Pubovaginal Sling for Stress Urinary Incontinence After the FDA Advisory Notification

“…17 More recently, Sharifiaghdas et al randomized 100 women with SUI to either autologous rectus fascia PVS or tension free vaginal tape (TVT). 18 Thirty-nine percent were lost to follow-up by 1 year. Of those who reached 1 year of follow-up, the mean follow-up time for the PVS and MUS was 40 and 38.5 months, respectively.…”