Transobturator tape for stress incontinence: The North Queensland experience

Naidu, Aruku; Lim, Yujin; Barry, Christopher; Goodwin, Samuel; Corstiaans, Audrey; Rane, Ajay

doi:10.1111/j.1479-828x.2005.00442.x

Cited by 24 publications

(13 citation statements)

References 19 publications

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“…Similarly, cure rates at 1 year have been reported to be 84 to 95% for sling procedures [11,16]. Similar high cure rates of 87 to 90% were reported after TOT procedures [17,18]. Our results for cure rates with both the TOT and Burch procedures are comparable to the published literature demonstrating the consistency of these procedures and strengthening the findings of our study.…”

Section: Discussionsupporting

confidence: 82%

A randomized comparison of transobturator tape and Burch colposuspension in the treatment of female stress urinary incontinence

et al. 2006

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This study was performed to compare the efficacy of transobturator tape (TOT) and Burch colposuspension in the treatment of female stress urinary incontinence (SUI). This is a prospective randomized single blind study of 100 women diagnosed as with urodynamic SUI who were randomized either to TOT procedure (n = 49) or Burch procedure (n = 51). The outcome was evaluated at 1 and 2 years. The mean operation time and hospital stay were significantly shorter in the TOT group compared to Burch group (p < 0.001). Procedure-related complications and postoperative voiding problems including postoperative urinary retention, de novo voiding difficulties and de novo urge incontinence were similar in the two groups. Both the subjective and objective cure rates of SUI at 1 year were 85.7 and 87.5%, respectively, in the TOT group. This was similar to subjective and objective cure rates at one year of 84.3% (p = 0.8) and 80.3% (p = 0.4) in the Burch group, respectively. At the end of 2 years, 32 patients were available in the TOT group and 31 patients were available in the Burch group for analysis. Both the subjective and objective cure rates of SUI at 2 years were 87.5 and 87.5% in the TOT group which was similar to the 87% (p = 0.9) and 83.8% (p = 0.6) in the Burch group, respectively. TOT procedure results in similar cure rates of SUI at 1 and 2 years compared to Burch procedure. The TOT procedure has a shorter operative time and length of hospital stay.

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Section: Discussionsupporting

confidence: 82%

A randomized comparison of transobturator tape and Burch colposuspension in the treatment of female stress urinary incontinence

et al. 2006

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“…Improvements in objective and subjective outcomes for UDS have been well documented previously for both techniques [2,33,34,41,43], [8,14,17,28,29,42], and these results confirm the high success rates for improvement of urinary incontinence. There were no significant differences in the incidence of objective and subjective cure rates, voiding dysfunction, overactive bladder, QoL markers and satisfaction rates despite early studies demonstrating short term improvement as possibly being superior to that of the retro-pubic approach (80-91%) [7,29]. Consistent with previous studies, these procedures significantly improve QoL [27,35].…”

Section: Discussionsupporting

confidence: 75%

“…The TVT procedures were performed as described by Ulmsten except that the choice of anaesthesia was left to the surgeon [40]. The Monarc slings were performed as described in our earlier series [29], but to standardise sling tension, surgeons were requested to perform either a cough test or simulated cough (Crede manoeuvre) with 300 ml of water in bladder intra-operatively for both procedures. Catheters were not routinely placed post-operatively in patients undergoing sling surgery alone, unless intra-operative bladder injury occurred, whereby catheter would then be left in overnight.…”

Section: Surgical Techniquementioning

confidence: 99%

A multi-centre, randomised clinical control trial comparing the retropubic (RP) approach versus the transobturator approach (TO) for tension-free, suburethral sling treatment of urodynamic stress incontinence: the TORP study

et al. 2007

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To compare the safety and efficacy of the transobturator tape (Monarc) with the retropubic tape (tension-free vaginal tape, TVTR) for the treatment of urodynamic stress incontinence (USI) a prospective, single-blinded, multi-centre randomised clinical controlled trial was undertaken in four urogynaecology units in Australia. One hundred and eighty-seven women with USI were randomly allocated to undergo surgery with either the Monarc sling (n = 80) or TVT (n = 107). Outcome measures were intra-operative complications (especially bladder injury), as well as peri-operative complications, symptomatology, quality of life and urodynamic outcomes. At 3 months, data were available on 140 women, 82 (59%) TVT and 58 (42%) Monarc. The TVT group was significantly more likely to be complicated by bladder injury (7 TVT, 0 Monarc, p < 0.05). Blood loss and operative time were significantly less in the Monarc group, which was 49 mls (31) vs that of the TVT group, which was 64 mls (41) p < 0.05; 18.5 min (6.5) TVT vs 14.6 min (6) Monarc (p < 0.001). The subjective and objective stress incontinence cure rates were 86.6% (71) vs 72.4% (42) p = 0.77 and 79.3 vs 84.5%, p = 0.51 for the TVT and Monarc groups, respectively. Both groups reported similar improvement in incontinence impact and satisfaction with their operation, although return to activity was significantly quicker with the transobturator route (p = 0.029). The transobturator tape appears to be as effective as the retro-pubic tape in the short term, with a reduction in the risk of intra-operative bladder injury, shorter operating time, decreased blood loss, and quicker return to usual activities.

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“…Many authors worldwide have now published their results and experiences with the TOT [10][11][12][13][14][15][16][17][18][19][20][21][22]. We report shortterm success rates of 89.3% at 3 months which compares favorably to the patient-reported success at this time of 85.2%.…”

Section: Discussionmentioning

confidence: 55%

Safety and efficacy of the transobturator tape for stress urinary incontinence: short-term and medium-term results of 125 patients demonstrate a procedure-related learning curve

Church

Hanna

2009

Gynecol Surg

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Our aim was to assess the safety and efficacy of the transobturator tape (TOT) for the surgical treatment of female stress urinary incontinence. We report our initial experience in a district general hospital and study the learning curve effect. This is a retrospective study of the first 125 women to have the TOT procedure (Aris® Transobturator Tape). Short-term follow-up took place with the operating gynecologist in the clinic 3 months postoperatively, while medium-term follow-up was assessed by a patient questionnaire at 18-36 months (mean 23 months). Short-term success rate was 89.3%. Complications were bladder injury 2.4%, postoperative urinary tract infection 8.1%, transient voiding dysfunction 13.7%, tape erosion 4.1%, and de novo urgency 14%. Questionnaire response rate was 66%. Subjective cure at 18-36 months was 81.5% with 88.9% reporting an improvement in quality of life. Ten women underwent repeat TOT after primary procedure failure with 80% success. Tape erosion occurred up to 17 months postoperatively, thus overall incidence was 6.4%. The incidence of bladder injury, tape erosion, and tape failure was higher in the first 60 patients, thus we performed an analysis of these events by the number of procedures performed and demonstrated a definite learning curve. The TOT is a safe and effective surgical treatment for stress urinary incontinence; however, as for all new surgical procedures, there exists a learning curve.

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Transobturator tape for stress incontinence: The North Queensland experience

Cited by 24 publications

References 19 publications

A randomized comparison of transobturator tape and Burch colposuspension in the treatment of female stress urinary incontinence

A randomized comparison of transobturator tape and Burch colposuspension in the treatment of female stress urinary incontinence

A multi-centre, randomised clinical control trial comparing the retropubic (RP) approach versus the transobturator approach (TO) for tension-free, suburethral sling treatment of urodynamic stress incontinence: the TORP study

Safety and efficacy of the transobturator tape for stress urinary incontinence: short-term and medium-term results of 125 patients demonstrate a procedure-related learning curve

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