Tension-Free Vaginal Tape Versus Transobturator Suburethral Tape: Five-Year Follow-up Results of a Prospective, Randomised Trial

Angioli, Roberto; Plotti, Francesco; Muzii, Ludovico; Montera, Roberto; Panici, Pierluigi Benedetti; Zullo, Marzio Angelo

doi:10.1016/j.eururo.2010.08.004

Cited by 96 publications

(92 citation statements)

References 24 publications

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“…This is consistent with the 11% reported rate at 2-3 years after TVT-S procedures [4]. In contrast, recently published 5-year results from a randomized trial comparing TVT and TOT reported a long-term de novo urgency rate of 4% for first/s generation MUSs combined [18]. This was unchanged from the rate of de novo OAB at 1 year (4%) from the same trial, which was previously reported [19].…”

Section: Discussioncontrasting

confidence: 33%

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

Walsh¹

2011

BJU International

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What’s known on the subject? and What does the study add?Although synthetic mid‐urethral slings are now generally accepted as the first‐line surgical treatment of female stress incontinence, there is concern that newer slings are being used prematurely, before sufficient evidence exists. The 3rd generation “mini‐slings” are inserted via a single incision which, theoretically, reduces iatrogenic morbidity. It is vital, however, that efficacy is not compromised. To date, a number of papers have examined short‐term outcome data following the TVT‐Secur, with wide variations in reported cure rates at up to one year.This is the largest review of outcomes following TVT‐Secur published to date (n= 1178 cases from 10 studies). Cure rate, both objectively and subjectively, was 76%, which is similar to more established mid‐urethral slings. Intra‐operative vaginal perforation rates and rates of mesh exposure in the first 12 months post‐operatively were both 2%. The incidence of de novo OAB was 10%. No serious complications were recorded amongst this large cohort. Although the TVT‐Secur appears to be a safe procedure, its long‐term efficacy moving forward requires close scrutiny.• Synthetic mid‐urethral slings (MUSs) are considered the first choice surgical procedure for stress urinary incontinence. Recent publications have raised concerns about the efficacy of third generation single‐incision mini‐slings. The present paper is a systematic review of studies reporting 12‐month outcomes after the TVT‐Secur (TVT‐S) procedure.• Pubmed/Medline online databases, abstracts from recent International Continence Society and International Urogynecological Association annual scientific meetings and the Clinicaltrials.gov and Controlled‐trials.com online trial registries were searched for English‐language articles containing the terms ‘TVT‐Secur’, ‘TVT Secur’ or ‘mini‐sling’. The primary outcomes were objective and subjective cure rates at 12 months. Secondary outcomes included peri‐operative (vaginal perforation, urinary retention, urinary tract infection [UTI]) and postoperative (mesh exposure, de novo overactive bladder (OAB), dyspareunia and return to theatre) complication rates.• Among 1178 women undergoing the TVT‐S procedure, from 10 studies, both objective and subjective cure rate at 12 months was 76%, with objective cure significantly higher in women undergoing the ‘U‐type’ approach. Vaginal perforation was a complication in 1.5% of cases, with a 2.4% incidence of mesh exposure in the first year. The incidence of de novo OAB symptoms was 10%. Rates of urinary retention (2.3%), UTI (4.4%), dyspareunia (1%) and return to theatre for complications (0.8%) were low. In the first year after a TVT‐S procedure 5% of women required repeat continence surgery.• Longer‐term studies and randomized comparisons with more established MUSs are required before TVT‐S should be routinely used in the surgical treatment of stress urinary incontinence.

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Section: Discussioncontrasting

confidence: 33%

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

Walsh¹

2011

BJU International

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“…Virtually all slings are made of synthetic material, predominantly monofilament polypropylene. 17 A recent prospective study comparing the two techniques demonstrated similar success rates (TOT: 72.9%; TVT: 71%) and complication rates (TVT: 17.2%; TOT: 16.1%) after a 5-year follow-up. 17 Thus, intuitively, sub-urethral slings might be a treatment option in female patients with stress urinary incontinence due to neurogenic bladder dysfunction as well, but the clinical experience in women with spinal cord lesion is still limited.…”

mentioning

confidence: 95%

“…17 A recent prospective study comparing the two techniques demonstrated similar success rates (TOT: 72.9%; TVT: 71%) and complication rates (TVT: 17.2%; TOT: 16.1%) after a 5-year follow-up. 17 Thus, intuitively, sub-urethral slings might be a treatment option in female patients with stress urinary incontinence due to neurogenic bladder dysfunction as well, but the clinical experience in women with spinal cord lesion is still limited. 6 Hamid et al were the first to report the use of TVT in 12 patients with neurogenic bladder dysfunction with a subjective sure rate of 83.3%, which is comparable to the data reported in patients with non-neurogenic bladder dysfunction.…”

mentioning

confidence: 95%

Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion

Pannek

Bartel

Göcking

2012

The Journal of Spinal Cord Medicine

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Objectives: To evaluate the clinical usefulness of transobturator sub-urethral tapes for the treatment of stress urinary incontinence in women with spinal cord injury. Method and subjects: Chart review for all female patients with spinal cord injury who underwent implantation of a transobturator sub-urethral tape for treatment of stress urinary incontinence at our institution. Results: Nine women, median age 45.1 years, received a sub-urethral transobturator tape in the period November 2007 to September 2010. Four patients had paraplegia and five had tetraplegia. Seven women performed intermittent catheterization. At follow up, three of the nine patients were either cured or vastly improved. One major late complication (urethral erosion) occurred. Five of the six patients without treatment success underwent second-line treatment (artificial sphincter or urinary diversion). Conclusion: In our case series, implantation of transobturator sub-urethral tapes in women with stress urinary continence due to intrinsic sphincter deficiency and a low leak point pressure led to unfavorable results.

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“…Further sensitivity analyses limited to the 5 RCTs with follow-up durations >60 mo [21,34,[37][38][39] demonstrated similar outcomes for RP-TVT and TO-TVT in terms of objective cure rate, subjective cure rate, vaginal erosions, storage and voiding LUTS, and reoperation rates (see supplemental figure 1). …”

Section: Randomized Controlled Trials Comparing Retropubic With Transmentioning

confidence: 99%

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

et al. 2017

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CONTEXT: Retropubic (RT-TVT) and transobturator miurethral (TO-TVT) mid-urethral sling (MUS) are popular surgical treatments for female stress urinary incontinence (SUI). The long-term efficacy and safety of the procedures is still a topic of intense clinical research and several randomized controlled trials (RCTs) have been published in the last years OBJECTIVE: To evaluate the efficacy and safety of MUS compared with other surgical treatments for female SUI. EVIDENCE ACQUISITION:A systematic review and meta-analysis of the literature was performed using the Medline, Scopus, and Web of Science databases to update our previously published analyses. EVIDENCE SYNTHESIS:Twenty-eight RCTs were identified. In total, the meta-analyses CONCLUSIONS:The present analysis confirms the superiority of MUS over BC. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of 3 inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT. PATIENT SUMMARY:Retropubic and transobturator midurethral slings are a popular treatment for female stress urinary incontinence. The available literature suggest that those slings are either more effective or safer than other older surgical procedures. Retropubic tapes are followed with slightly higher continence rates as compared with the transobturator tapes but are associated with higher risk of intra-and postoperative complications. TAKE-HOME MESSAGESThe present analysis confirms the superiority of MUS over Burch colposuspension. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT 4

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Tension-Free Vaginal Tape Versus Transobturator Suburethral Tape: Five-Year Follow-up Results of a Prospective, Randomised Trial

Cited by 96 publications

References 24 publications

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

TVT‐Secur mini‐sling for stress urinary incontinence: a review of outcomes at 12 months

Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

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