Tension-Free Vaginal Tape versus Transobturator Tape as Surgery for Stress Urinary Incontinence: Results of a Multicentre Randomised Trial

Porena, Massimo; Costantini, Elisabetta; Frea, Bruno; Giannantoni, Antonella; Ranzoni, S.; Mearini, Luigi; Bini, Vittorio; Kocjancic, Ervin

doi:10.1016/j.eururo.2007.04.059

Cited by 179 publications

(133 citation statements)

References 27 publications

Supporting

Mentioning

104

Contrasting

Unclassified

Order By: Relevance

“…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

View full text Add to dashboard Cite

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...

show abstract

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

View full text Add to dashboard Cite

show abstract

“…13 Our data are also consistent with large international trials demonstrating similar improvements in QoL after RMUS and TMUS. 2,14,15 Porena et al 14 used the IIQ-7 to assess QoL changes and found no differences between the RMUS and TMUS procedures with scores decreasing from 8 to 0 at 1 year. Meschia et al 16 used the ICIQ to assess improvements in QoL also showing 80 to 85% improvements in overall scores.…”

Section: Discussionmentioning

confidence: 99%

174 Condition specific quality of life 24 months after retropubic and transobturator sling surgery for stress urinary incontinence

Sirls¹,

Tennstedt²,

Lukacz³

et al. 2012

European Urology Supplements

View full text Add to dashboard Cite

Aims-To compare quality of life (QoL) and factors associated with QoL change after retropubic (RMUS) and transobturator (TMUS) midurethral slings using the Incontinence Impact Questionnaire, (IIQ) and the International Consultation on Incontinence Questionnaire (ICIQ).Methods-Five hundred ninety seven women in a multicenter randomized trial of RMUS vs. TMUS were examined. The IIQ and ICIQ were obtained at baseline, 12 and 24 months. Repeated measures analysis of variance tested for differences by treatment group over time. Multivariable analysis identified factors associated with QoL change at 12 months post-operative, controlling for treatment group and baseline QoL.Results-Improvement in IIQ was associated with: treatment success, younger age, improvement in stress incontinence (SUI) symptom severity and bother (all p < 0.05). Improvement in ICIQ was associated with treatment success, younger age, improvement in SUI symptom severity and bother, lower body mass index and no re-operation (all p < 0.05). Improvement of the IIQ was stable over time (p =0.35) for both treatment groups (p=0.66) whereas the ICIQ showed a small but clinically insignificant decline (p=0.03) in both treatment groups (p=0.51).

show abstract

“…Šiai operacijai nebūdingas šlapimo pūslės pažeidimas, su mažėja žarnų ir kraujagyslių pažeidimų. Be to, TOT opera cijai atlikti, kad būtų pasiekta gerų pooperacinių rezultatų, pakanka neilgo mokymosi [7], todėl mūsų tyrimo tikslas buvo įvertinti TOT operacijos efektyvumą ir patirties įtaką atokiems pooperaciniams rezultatams.…”

Section: įVadasunclassified

“…pacien čių, kai net 45,3 proc. pacienčių minėjo simptomus, būdin gus tiek įtampos šlapimo nelaikymui, tiek dirgliosios šlapi mo pūslės sindromui [7]. Pasirenkant operacinį gydymą ir konsultuojant pacientes dėl numatomo operacijos efekty vumo, reikėtų pabrėžti galimus likusius šlapimo nelaikymo simptomus.…”

Section: Rezultatų Aptarimasunclassified

Įgytos Patirties Įtaka Šlapimo Nelaikymo Korekcijos Transobturatoriniu Raiščiu Rezultatams

Jukna

Smelevičienė²,

Mečėjus³

2017

Medicinos Teorija Ir Praktika

View full text Add to dashboard Cite

Reikšminiai žodžiai: šlapimo nelaikymas dėl įtampos, TOT operacija, patirtis, efektyvumas. Darbo tikslas. Įvertinti įgytos operacinės patirties įtaką šlapimo nelaikymo korekcijos transobturatoriniu raiščiu (TOT operacijos) rezultatams, gydant įtampos šlapimo nelaikymą arba mišrų šlapimo nelaikymą, vyraujant įtampos šlapimo nelaikymui. Darbo metodika. Tai yra prospektyvinis tyrimas, apimantis TOT operacijas, atliktas nuo 2014 m. sausio mėnesio iki 2014 m. gruodžio mėnesio Vilniaus miesto klinikinės ligoninės (VMKL) Ginekologijos skyriuje. Į tyrimą įtraukti visi atvejai, kai pacientėms dėl įtampos arba mišraus šlapimo nelaikymo, vyraujant įtampos šlapimo nelaikymui, atliktos TOT operacijos, implantuojant sintetinį raištį. Indikacija operaciniam gydymui buvo šlapimo nelaikymas dėl įtampos arba mišrus šlapimo nelaikymas, vyraujant įtampos šlapimo nelaikymui. Tyrimo metu buvo pateiktos originalios anketos prieš operaciją ir praėjus metams po jos. Anketose prieš operaciją buvo surinkti pacienčių anamnezės ir gyvenimo kokybės duomenys, o anketose, pateiktose praėjus metams po atliktos operacijos, buvo vertinamas operacijos efektyvumas, pooperacinė eiga ir nepageidaujami požymiai. Gauti rezultatai palyginti su prospektyvinio tyrimo, atlikto 2012 m. VMKL Ginekologijos skyriuje, rezultatais. Rezultatai. 2014 m. iš viso atliktos 98 TOT operacijos. Į tyrimą įtrauktos 54 (55 proc. operuotų) pacientės. Likusios atkrito dėl duomenų trūkumo arba buvo nesurastos praėjus 1 metams po operacijos. Iki operacijos izoliuotas įtampos šlapimo nelaikymas buvo nustatytas 25 (46,3 proc.) pacienčių, mišrus šlapimo nelaikymas, vyraujant įtampos šlapimo nelaikymui, – 29 (53,7 proc.). Po 1 metų 30 (55,6 proc.) pacienčių neliko jokių šlapimo nelaikymo simptomų, 21 (38,9 proc.) pacientei buvo ryškus pagerėjimas, daliai jų su išlikusiais dirgliosios šlapimo pūslės simptomais. Operacijos bendras efektyvumas buvo 94,5 proc. 2012 m. VMKL Ginekologijos skyriuje atliktame tyrime, į kurį buvo įtraukta 40 pacienčių, operacijos efektyvumas praėjus metams po operacijos buvo 92,5 proc.: 57,5 proc. pacienčių neliko jokių šlapimo nelaikymo simptomų ir 35 proc. moterų buvo ryškus pagerėjimas su išlikusiais dirgliosios šlapimo pūslės simptomais. Operacinio gydymo rezultatas didėjant patirčiai yra geresnis, tačiau statistiškai nereikšmingas (p > 0,05). Išvados. TOT operacija gydant įtampos šlapimo nelaikymą yra auksinis standartas, nes efektyvi, saugi, ilgalaikė ir sukelia tik kelias nedideles komplikacijas. Didėjant atliekamų operacijų skaičiui, didėja patirtis ir gerėja operacijos efektyvumas, tačiau priimtini geri rezultatai gaunami net ir po pirmųjų operavimo metų. Šios operacijos mokymosi kreivė yra trumpa.

show abstract

Tension-Free Vaginal Tape versus Transobturator Tape as Surgery for Stress Urinary Incontinence: Results of a Multicentre Randomised Trial

Cited by 179 publications

References 27 publications

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

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

174 Condition specific quality of life 24 months after retropubic and transobturator sling surgery for stress urinary incontinence

Įgytos Patirties Įtaka Šlapimo Nelaikymo Korekcijos Transobturatoriniu Raiščiu Rezultatams

Contact Info

Product

Resources

About