Tension-free Vaginal Tape for the Treatment of Urodynamic Stress Incontinence: Efficacy and Adverse Effects at 10-Year Follow-Up

Serati, Maurizio; Ghezzi, Fabio; Cattoni, Elena; Braga, Andrea; Siesto, Gabriele; Torella, Annalaura; Cromi, Antonella; Vitobello, Domenico; Salvatore, Stefano

doi:10.1016/j.eururo.2012.01.038

Cited by 101 publications

(85 citation statements)

References 29 publications

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“…12 These 5 year outcomes were relatively less satisfactory when compared with those previously reported at one, three, and four years by most other authors, 10,14,15 and also with our current data. However, one limitation of their interesting randomized study could be the very limited sample size, which likely influenced the cure rates reported.…”

Section: Discussioncontrasting

confidence: 56%

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Transobturator tension-free vaginal tape is the most common procedure in women with stress urinary incontinence: our experience

Gentile¹,

Giulianelli²,

Albanesi³

et al. 2014

UIJ

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Transobturator tension-free vaginal tape (TVT-O) surgery is currently one of the most effective procedures used to treat women with stress urinary incontinence (SUI), however, long-term follow-up data in medical literature is scarce. For this study, we enrolled women with SUI assessed by an urodynamic examination and a translabial ultrasound with a pelvic organ prolapse no greater than grade 2. All of the women were also given a pre-and postoperative test to assess their quality of life. They were given a thorough physical examination, asked to keep a voiding diary, and underwent an urodynamic examination and a translabial ultrasound. Additionally, we also further evaluated intraoperative and postoperative complications and the onset of de novo detrusor overactivity after the procedure. We also assessed the long-term efficacy of the TVT-O in those women with SUI caused by sphincter hypotonia. All of the women underwent TVT-O surgery without any associated procedure. Our findings indicate that TVT-O surgery is an effective treatment option for women with SUI, showing a very high cure rate and a low incidence of complications, with sustained outcomes even in the long-term. However, in women with SUI caused by sphincter hypotonia, the excellent outcomes in early stages tend to dwindle over time.

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Section: Discussioncontrasting

confidence: 56%

“…Previous studies have reported de novo urgency rates ranging from 4% to 33% after the retropubic TVT procedure 10 and 18 but few works are available on the relationship between TVT-O and the onset of de novo OAB in the medium-term.…”

Section: Discussionmentioning

confidence: 99%

Transobturator tension-free vaginal tape is the most common procedure in women with stress urinary incontinence: our experience

Gentile¹,

Giulianelli²,

Albanesi³

et al. 2014

UIJ

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“…Furthermore, our results are comparable to those achieved in the general population undergoing TOT surgery. [17][18][19][20] The reason for these good results is not clear-it may be that in our homogenous population of women with neuropathic bladders, bladder and outlet pathology is better understood. It may be also that these women are inherently less mobile and less active-both in the immediate post-operative period (hence putting their TOT under less stress) and in the long term (hence not subjecting their TOT to the same degree of strain as in a neurologically intact woman).…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of transobturator tape (TOT) for treatment of stress urinary incontinence in females with neuropathic bladders

et al. 2015

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Study design: Retrospective review of prospectively collected data. Objectives: Stress urinary incontinence (SUI) is a cause of significant distress in women with neurogenic bladder dysfunction (NBD) due to spinal cord injury (SCI). Transobturator tape (TOT) has not previously been studied in this select group for cure of SUI. We aim to determine the long-term safety and efficacy of TOT in SCI patients with NBD and SUI. Setting: London, the United Kingdom. Methods: All patients undergoing TOT between 2005 and 2013 were identified (27 patients). All patients had pre-operative videocystometrogram (VCMG) and all had VCMG-proven SUI. Mean follow-up was 5.2 years. Patient-reported leakage, satisfaction, change in bladder management, complications and de novo overactive bladder (OAB) were recorded. Results: Mean age was 56 years (range 30-82) with complete follow-up. Twenty-two patients (81.5%) reported complete dryness from SUI post surgery. One patient (3.7%) reported SUI only when her bladder was very full but was satisfied. Twenty-three patients (85.2%) were happy. Four patients (14.8%) remained wet. Twenty-five patients (92.6%) had no change in bladder management. Two out of five patients (40%) who voided by straining prior to surgery required clean intermittent self-catheterisation (CISC) postoperatively. Two patients (7.4%) developed de novo OAB. No bladder or vaginal injuries, tape erosions or urethral obstruction were seen. Three patients (11.1%) had transient thigh pain. Conclusion: In women with NBD and SUI, TOT should be considered safe and effective with very good medium/long-term outcomes. There may be an increased risk of CISC in women who void by straining pre-operatively. INTRODUCTIONStress urinary incontinence (SUI) in women with neuropathic bladder dysfunction 1 (NBD) can be a major disabling feature. In the general population up to 25% of women are thought to be affected, 2 although among neuropaths the incidence remains unknown.In women with NBD, such as after spinal cord injury (SCI), there are specific additional problems compared with the general population that require consideration. For instance, neuropathic patients may have neurogenic detrusor overactivity (NDO) in association with weakness of the external urethral sphincter or a weak sphincter with an acontractile bladder. Particularly after childbirth, this sphincteric dysfunction may be seen in association with hypermobility or prolapse, which can further complicate management.Following Ulmsten's original description 3 in 1996 of a synthetic polypropylene tension-free vaginal tape placed at a mid-urethral level in retropubic fashion, our unit was the first to study the success of this procedure in neuropathic patients. 4,5 This showed success comparable to non-neuropaths in both short and long term with few complications. The aim of this study was to present the first series of long-term safety and efficacy outcomes of placement of mid-urethral synthetic transobturator tapes (TOT) in patients with urodynamically confirmed SUI and NBD du...

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“…The procedure is minimally invasive, with a shorter operative duration and can be undertaken electively as a day case. Besides, its effectivity and having high cure rates for ten years, so the TVT procedure is widely acknowledged as the current gold standard surgical treatment for SUI [26]. TVT procedures have subjective cure rates that are comparable to retropubic colposuspension with lesser perioperative complications, less postoperative voiding dysfunction, shorter operative time and hospital stay, but quite more bladder perforations.…”

Section: Tension-free Vaginal Tapementioning

confidence: 99%

Surgical Management of Urinary Stress Incontinence

Kececioglu¹

2016

Med-Science

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Tension-free Vaginal Tape for the Treatment of Urodynamic Stress Incontinence: Efficacy and Adverse Effects at 10-Year Follow-Up

Cited by 101 publications

References 29 publications

Transobturator tension-free vaginal tape is the most common procedure in women with stress urinary incontinence: our experience

Transobturator tension-free vaginal tape is the most common procedure in women with stress urinary incontinence: our experience

Long-term outcome of transobturator tape (TOT) for treatment of stress urinary incontinence in females with neuropathic bladders

Surgical Management of Urinary Stress Incontinence

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