Inside out transobturator vaginal tape for the treatment of female stress urinary incontinence: Interim results of a prospective study after a 1-year minimum followup
female; urinary incontinence, stress; prostheses and implants; vagina; urethra
Abstract :
[en] Purpose: We analyzed the results of a prospective, observational trial designed to assess the safety and efficacy of the TVT-O procedure for female SUI. Materials and Methods: Preoperative and postoperative evaluations included physical examination, and urinary symptom and quality of life scale questionnaires. Results: Between March 2003 and December 2004, 253 patients with clinical and urodynamic diagnoses of SUI who fulfilled inclusion and exclusion criteria were enrolled in the trial and underwent the TVT-O procedure. No significant intraoperative complications were observed. One-year minimum followup was available on 99 of the initial 102 patients, of whom 16 had undergone concomitant pelvic organ prolapse surgical treatment. The SUI complete cure rate was 91%. No patient had vaginal or urethral erosion. Four patients required tape release or section. Frequency and urge symptoms improved after the operation (p < 0.001). The severity of obstructive symptoms slightly increased postoperatively in the group of patients who did not undergo associated pelvic organ prolapse treatment (p < 0.05), while maximum flow rates somewhat decreased (p < 0.001) and post-void residual urine volumes somewhat increased (p < 0.005). Most patients reported a significant decrease in incontinence severity and improvement in quality of life (p < 0.0001). Conclusions: The results of this study, which suggest that the TVT-O procedure is a safe and efficient surgical treatment for female SUI, warrant further comparative evaluation of this procedure with retropubic and outside in transobturator approaches in appropriately designed, prospective, randomized trials.
Disciplines :
Urology & nephrology
Author, co-author :
Waltregny, David ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Labo de recherche sur les métastases
Reul, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Urologie
Mathantu, Balombi
Gaspar, Yves
Bonnet, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Urologie
De Leval, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Urologie
Language :
English
Title :
Inside out transobturator vaginal tape for the treatment of female stress urinary incontinence: Interim results of a prospective study after a 1-year minimum followup
Publication date :
June 2006
Journal title :
Journal of Urology
ISSN :
0022-5347
eISSN :
1527-3792
Publisher :
Lippincott Williams & Wilkins, Philadelphia, United States - Pennsylvania
Nilsson C.G., Kuuva N., Falconer C., Rezapour M., and Ulmsten U. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct, suppl. 14 (2003) S35
Boustead G.B. The tension-free vaginal tape for treating female stress urinary incontinence. BJU Int 89 (2002) 687
Delorme E. Transobturator urethral suspension. mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 11 (2001) 1306
Mellier G., Benayed B., Bretones S., and Pasquier J.C. Suburethral tape via the obturator route. is the TOT a simplification of the TVT?. Int Urogynecol J Pelvic Floor Dysfunct 15 (2004) 227
Dargent D., Bretones S., George P., and Mellier G. Insertion of a suburethral sling through the obturating membrane for the treatment of female urinary incontinence. Gynecol Obstet Fertil 30 (2002) 576
Delmas V., Hermieu J.F., Dompeyre P., Messas A., Dumonceau O., Ravery V., et al. The transobturator slingtape uratape. anatomical dangers. Eur Urol, suppl. 2 (2003) 197
Hermieu J.F., Messas A., Delmas V., Ravery V., Dumonceau O., and Boccon-Gibod L. Plaie vésicale après bandelette trans-obturatrice. Prog Urol 13 (2003) 115
de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence. transobturator vaginal tape inside-out. Eur Urol 44 (2003) 724
Costa P., Grise P., Droupy S., Monneins F., Assenmacher C., Ballanger P., et al. Surgical treatment of female stress urinary incontinence with a trans-obturator-tape (T.O.T.) Uratape®. short term results of a prospective multicentric study. Eur Urol 46 (2004) 102
Minaglia S., Ozel B., Klutke C., Ballard C., and Klutke J. Bladder injury during transobturator sling. Urology 64 (2004) 376
Krauth J.S., Rasoamiaramanana H., Barletta H., Barrier P.Y., Grisard-Anaf M., Lienhart J., et al. Sub-urethral tape treatment of female urinary incontinence-morbidity assessment of the trans-obturator route and a new tape (I-STOP). a multi-centre experiment involving 604 cases. Eur Urol 47 (2005) 102
Cindolo L., Salzano L., Rota G., Bellini S., and D'Afiero A. Tension-free transobturator approach for female stress urinary incontinence. Minerva Urol Nefrol 56 (2004) 89
Bonnet P., Waltregny D., Reul O., and de Leval J. Transobturator vaginal tape inside out for the surgical treatment of female stress urinary incontinence. anatomical considerations. J Urol 173 (2005) 1223
Rogers R., Lucente V., and Raders J. Anatomic considerations for the TVT-obturator approach for the correction of female stress urinary incontinence. UroToday (2004) 155 abstract 155
Marquis P., Amarenco G., Sapede C., Josserand F., McCarthy C., Zerbib M., et al. Elaboration and validation of a specific quality of life questionnaire for urination urgency in women. Prog Urol 7 (1997) 56
Villet R. Les prolapsus génitaux. In: Villet R., Buzelin J.-M., and Lazorthes F. (Eds). Les Troubles de la Statique Pelvipérinéale de la Femme (1995), Vigot, Paris 119-140
Delorme E., Droupy S., de Tayrac R., and Delmas V. Transobturator tape (Uratape). a new minimally-invasive procedure to treat female urinary incontinence. Eur Urol 45 (2004) 203
Albouy B., Sambuis C., Andreou A., Sibert L., and Grise P. Can transobturator tape for urinary incontinence cause complete urinary retention?. Prog Urol 14 (2004) 189
Ozel B., Minaglia S., Hurtado E., Klutke C.G., and Klutke J.J. Treatment of voiding dysfunction after transobturator tape procedure. Urology 64 (2004) 1030
Barry, C., Naidu, A., Lim, Y., Corsitaans, A., Muller, R. and Rane, A.: Does the MONARC transobturator suburethral sling cause post-operative voiding dysfunction? A prospective study. Int Urogynecol J Pelvic Floor Dysfunct, Epub ahead of print August 11, 2005