Transobturator tape and mini-sling methods in stress urinary incontinence: Results of a randomized clinical trial

Abstract

Background: Stress urinary incontinence is one of the most common types of incontinence in premenopausal women, accounting for almost 50% of such cases. Mid-urethral slings are currently the most widely used surgical method for stress urinary incontinence. This study aimed at comparing the efficacy, complications, urodynamic changes and the sexual function status between mini-sling surgery and transobturator tape to help us select the best method in such patients. Method: In this randomized controlled trial, 80 cases were studied and randomly assigned to either the mini-sling or transobturator tape group (n = 40). A full medical history was taken and the Q.tip and cough tests were performed for each patient to record their urinary incontinence and hypermobility. Abdominal and pelvic ultrasound study was requested by specifying PVR and urodynamic testing. The International Consultation on Incontinence Modular Questionnaire-6 was filled by the patients and the Female Sexual Functioning Index questionnaire by the physician. The patients were followed-up 8 weeks after discharge by urodynamic tests, ultrasound study, and the International Consultation on Incontinence Modular Questionnaire test. Results: The mean age, body mass index, and parity were not significantly different between the two groups. The mean surgical time, amount of bleeding, hospitalization period, and pain index were significantly less in the mini-sling group. The International Consultation on Incontinence Modular Questionnaire and Female Sexual Functioning Index indices before and after surgery showed no significant difference between the two groups. The difference in urodynamic test parameters was also insignificant. Conclusion: In the mini-sling method which is a less invasive method compared to transobturator tape, the intraoperative bleeding, surgical time, hospitalization period, pain, and surgical complications were far less while its efficacy was similar to transobturator tape; therefore, it is recommended in treating stress urinary incontinence among women.

Handmade Needleless Midurethral Sling In Comparison With Transobturator Tension-Free Vaginal Tape In Treatment Of Genuine Female Stress Urinary Incontinence

“…are similar to what was mentioned by other study [18] as mean operative time was 25 + 9.48 min and also consistent with another one [19] which reported a mean surgical time of 6.9 ± 1.83 min in the mini-sling which was significantly less than that reported in the TOT group 11.5 ± 5.01 min. Operative time was shorter in group I as there was no need for skin or groin incision and no need for trans obturator passage.…”

“…The intra-operative blood loss was insignificantly different between both groups which agreed with what was reported by other studies [20,21] but pervious study [19] stated that the mini-sling group demonstrated significantly less blood loss than the other group. Another study [8] reported 47.7 ml blood loss during using surgeon tailored needleless mesh and this was similar to our results.…”

“…No intraoperative complications as iatrogenic bladder perforation or urethral injury were reported in any of the included groups which is consistent with the results reported [8,9,23] and agreed with other studies [16,21] which reported no organ perforation but other study [24] reported 3 cases of bladder perforation especially with previous prolapse surgery also another one [19] reported vaginal perforation in 2 patients of the TOT group.…”

Trans Obturator Tape (TOT) Procedure in cases of Stress Urinary Incontinence: Patients' Satisfaction and Cure Rates (Retrospective Analysis)

“…IQ: Interquartiles. Table(5) showed that: among the studied cases; leak was reported in less than half of cases (44.3%).Total=79. IQ: Interquartiles.…”

“…4 When conservative treatment fails, the surgical treatment is resorted in the form of mid urethral slings. 5 The most common performed procedures now for treating SUI are the mid urethral slings are currently TOT and tension free vaginal tape (TVT) on top of these procedures. 6 The common point of mid urethral sling operations is the use of mesh material passed under the urethra.…”