Article (Scientific journals)
New surgical technique for treatment of stress urinary incontinence TVT-ABBREVO: From development to clinical experience
Waltregny, David; de Leval, Jean
2012In Surgical Technology International, XXII (pii), p. 22/23
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Keywords :
stress urinary incontinence; transobturator; TVT-ABBREVO
Abstract :
[en] Tension-free suburethral tapes have revolutionized the surgical treatment of female stress urinary incontinence (SUI). These tapes are inserted by way of a retropubic or transobturator route. The inside-out tension-free vaginal tape transobturator approach, or TVT-Obturator system (TVT-O®, Ethicon Women's Health and Urology, Somerville, NJ), was developed ten years ago with the aim of minimizing the risk of urinary tract injuries associated with retropubic and outside-in transobturator tapes while reproducibly ensuring minimal tissue dissection. Cadaveric studies have shown that the anatomical trajectory of the TVT-O tape is strictly perineal and courses away from neighboring obturator and pudendal neurovascular structures. Several meta-analyses have shown similar SUI cure rates after retropubic and transobturator tape procedures. Yet, the transobturator route may be associated with less voiding dysfunction, blood loss, bladder perforation, and shorter operating time. The original TVT-O procedure was modified with the aim of reducing the incidence of postoperative groin pain as well as the rather theoretical risk of obturator nerve injury. This modified procedure, named TVT-ABBREVO® (Ethicon Women's Health and Urology, Somerville, NJ), utilizes a shortened, 12-cm-long polypropylene tape. In addition, perforation of the obturator membrane with the scissors and guide is avoided in order to reduce the depth of lateral dissection, and consequently, to maximize securing of the tape within the obturator muscular/aponeurotic structures. In a comparative anatomical study, it was indeed observed that the shorter tape traversed less muscular structures (with no or only a minimal amount of tape lying in the adductor muscles) than its original counterpart, while still consistently anchoring in the obturator membrane at a similarly safe distance from the obturator canal. In a single-center randomized clinical trial, after a 3-year minimum follow-up, the modified TVT-O procedure with a shorter tape and reduced dissection was found to be as safe and efficient as the primal procedure for treating female SUI, with less severe and frequent groin pain in the immediate postoperative period.
Disciplines :
Urology & nephrology
Author, co-author :
Waltregny, David  ;  Université de Liège - ULiège > Département des sciences cliniques > Urologie
de Leval, Jean ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
New surgical technique for treatment of stress urinary incontinence TVT-ABBREVO: From development to clinical experience
Publication date :
07 October 2012
Journal title :
Surgical Technology International
ISSN :
1090-3941
Publisher :
Universal Medical Press, San Francisco, United States - California
Volume :
XXII
Issue :
pii
Pages :
sti22/23
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 09 December 2012

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