Advertisement
Research Article| Volume 171, ISSUE 2, P376-380, December 2013

Download started.

Ok

Modified prepubic TVT-obturator tape procedure versus the conventional method: a preliminary study

  • Cheng-Yu Long
    Affiliations
    Graduate Institute of Medicine, Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
  • Ming-Ping Wu
    Affiliations
    Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan
    Search for articles by this author
  • Chiu-Lin Wang
    Affiliations
    Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
  • Kun-Ling Lin
    Affiliations
    Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
  • Cheng-Min Liu
    Affiliations
    Graduate Institute of Medicine, Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
  • Shu-Hui Wu
    Affiliations
    Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
  • Yung-Shun Juan
    Correspondence
    Corresponding author at: Department of Urology, Kaohsiung Medical University Hospital, 482 Shan-Ming Road, Hsiao-Kang Dist. 812, Kaohsiung, Taiwan. Tel.: +886 7 803 6783x3450; fax: +886 7 806 5068.
    Affiliations
    Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    Search for articles by this author
Published:September 30, 2013DOI:https://doi.org/10.1016/j.ejogrb.2013.09.018

      Abstract

      Objective

      To compare the efficacy and safety of the modified prepubic tension-free vaginal tape-obturator (PTVT-O) system procedure with the original TVT-O methods.

      Study design

      One hundred and ninety women with urodynamic stress incontinence (USI) were included in this study (93 cases in the TVT-O group and 97 in the PTVT-O group). Clinical assessments before and one year after surgery included urinalyses, 1-h pad tests, urodynamic studies, and a personal interview with the overactive bladder symptom score (OABSS) questionnaire.

      Results

      There were no differences between the two groups in mean age, parity, menopausal status, mean operative time and subjective cure rates (P > 0.05), but the efficacy of surgery (cure and improvement) in the PTVT-O group was significantly higher than that in the TVT-O group (P = 0.038). Complication rates and visual analog scale (VAS) scores were found to be similar (P > 0.05). OABSS decreased significantly after surgery in both groups (P < 0.05) although all urodynamic parameters revealed no significant difference after both procedures (P > 0.05).

      Conclusion

      Our modified procedure is a safe and effective treatment for female USI. It has an advantage over the original TVT-O with better surgical efficacy and comparable postoperative pain, although the follow-up times in this study are different.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Petros P.E.
        • Ulmsten U.I.
        An integral theory and its method for the diagnosis and management of female urinary incontinence.
        Scand J Urol Nephrol Suppl. 1993; 153: 1-93
        • Nilsson C.G.
        • Palva K.
        • Rezapour M.
        • Falconer C.
        Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence.
        Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19: 1043-1047
        • Meschia M.
        • Pifarotti P.
        • Bernasconi F.
        • et al.
        Tension-free vaginal tape: analysis of outcomes and complications in 404 stress incontinent women.
        Int Urogynecol J Pelvic Floor Dysfunct. 2001; 12: S24-S27
        • Long C.Y.
        • Lo T.S.
        • Liu C.M.
        • et al.
        Lateral excision of tension-free vaginal tape for the treatment of iatrogenic urethral obstruction.
        Obstet Gynecol. 2004; 104: 1270-1274
        • Delorme E.
        Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women.
        Prog Urol. 2001; 11: 1306-1313
        • de Leval J.
        Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out.
        Eur Urol. 2003; 44: 724-730
        • Richter H.E.
        • Albo M.E.
        • Zyczynski H.M.
        • et al.
        Retropubic versus transobturator midurethral slings for stress incontinence.
        N Engl J Med. 2010; 362: 2066-2076
        • Schierlitz L.
        • Dwyer P.L.
        • Rosamilia A.
        • et al.
        Effectiveness of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency: a randomized controlled trial.
        Obstet Gynecol. 2008; 112: 1253-1261
        • Long C.Y.
        • Hsu C.S.
        • Wu M.P.
        • Liu C.M.
        • Wu C.H.
        • Tsai E.M.
        Comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence.
        Curr Opin Obstet Gynecol. 2009; 21: 342-347
        • Waltregny D.
        • de Leval J.
        The TVT-obturator surgical procedure for the treatment of female stress urinary incontinence: a clinical update.
        Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20: 337-348
        • Homma Y.
        • Yoshida M.
        • Seki N.
        • et al.
        Symptom assessment tool for overactive bladder syndrome–overactive bladder symptom score.
        Urology. 2006; 68: 318-323
        • Abrams P.
        • Blaivas J.G.
        • Stanton S.L.
        • et al.
        The standardization of terminology of low urinary tract function recommended by the International Continence Society.
        Int Urogynecol J. 1990; 1: 45-58
        • Webster G.D.
        • Guralnick M.L.
        The neurourological evaluation.
        in: Walsh P.C. Retik A.B. Vaughan Jr., E.D. Wein A.J. Campbell's Urology. 8th ed. WB Saunders, Philadelphia2002: 900-930
        • Chapman C.R.
        • Casey K.L.
        • Dubner R.
        • Foley K.M.
        • Gracely R.H.
        • Reading A.E.
        Pain measurement: an overview.
        Pain. 1985; 22: 1-31
        • Abrams P.
        • Khoury S.
        • Wein A.
        International consultation on incontinence.
        WHO Health Publication Ltd., Geneva1999: 532 (Monaco 1998)
        • Meschia M.
        • Bertozzi R.
        • Pifarotti P.
        • et al.
        Peri-operative morbidity and early results of a randomized trial comparing TVT and TVT-O.
        Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18: 1257-1261
        • Long C.Y.
        • Jang M.Y.
        • Chen S.C.
        • et al.
        Changes in vesicourethral function following laparoscopic versus abdominal hysterectomy.
        Aust N Z J Obstet Gynaecol. 2002; 42: 259-263
        • Long C.Y.
        • Hsu S.C.
        • Wu T.P.
        • et al.
        Effect of laparoscopic hysterectomy on bladder neck and urinary symptoms.
        Aust N Z J Obstet Gynaecol. 2003; 43: 65-69
        • Hermieu J.F.
        • Messas A.
        • Delmas V.
        • et al.
        Bladder injury after TVT transobturator.
        Prog Urol. 2003; 13: 115-117
        • Neuman M.
        TVT and TVT-obturator: comparison of two operative procedures.
        Eur J Obstet Gynecol Reprod Biol. 2007; 131: 89-92
        • Leach G.E.
        • Dmochowski R.R.
        • Appell R.A.
        • et al.
        Female stress urinary incontinence clinical guidelines panel summary report on surgical management of female stress urinary incontinence. The American urological Association.
        J Urol. 1997; 158: 875-880
        • Latthe P.M.
        Review of transobturator and retropubic tape procedures for stress urinary incontinence.
        Curr Opin Obstet Gynecol. 2008; 20: 331-336
        • Araco F.
        • Gravante G.
        • Sorge R.
        • et al.
        TVT-O vs. TVT: a randomized trial in patients with different degrees of urinary stress incontinence.
        Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19: 917-926
        • Chen H.Y.
        • Ho M.
        • Hung Y.C.
        • et al.
        Analysis of risk factors associated with vaginal erosion after synthetic sling procedures for stress urinary incontinence.
        Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19: 117-121
        • Segal J.L.
        • Vassallo B.
        • Kleeman S.
        • et al.
        Prevalence of persistent and de novo overactive bladder symptoms after the tension-free vaginal tape.
        Obstet Gynecol. 2004; 104: 1263-1269
        • Ostergard D.R.
        The neurological control of micturition and integral voiding reflexes.
        Obstet Gynecol Surv. 1979; 34: 417-423
        • Long C.Y.
        • Hsu C.S.
        • Liu C.M.
        • Lo T.S.
        • Wang C.L.
        • Tsai E.M.
        Clinical and ultrasonographic comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence.
        J Minim Invasive Gynecol. 2008; 15: 425-430
        • de Leval J.
        • Thomas A.
        • Waltregny D.
        The original versus a modified inside-out transobturator procedure: 1-year results of a prospective randomized trial.
        Int Urogynecol J. 2011; 22: 145-156
        • Tommaselli G.A.
        • Formisano C.
        • Carlo C.D.
        • Fabozzi A.
        • Nappi C.
        Effects of a modified technique for TVT-O positioning on postoperative pain: single-blind randomized study.
        Int Urogynecol J. 2012; 23: 1293-1299
        • Zhang Y.
        • Jiang M.
        • Tong X.W.
        • Fan B.Z.
        • Li H.F.
        • Chen X.L.
        The comparison of an inexpensive modified transobturator vaginal tape versus TVT-O procedure for the surgical treatment of female stress urinary incontinence.
        Taiwan J Obstet Gynecol. 2011; 50: 318-321