scholarly journals Incisionless Pubovaginal Fascial Sling Using Transvaginal Bone Anchors for the Treatment of Stress Urinary Incontinence

2004 ◽  
Vol 4 ◽  
pp. 357-363 ◽  
Author(s):  
Sandip P. Vasavada ◽  
Craig V. Comiter ◽  
Shlomo Raz
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Minimally Invasive ◽  
Urge Incontinence ◽  
Bladder Neck ◽  
Long Term Results ◽  
Invasive Technique ◽  
Fascial Sling

Introduction: Bladder neck suspension (BNS) for stress urinary incontinence (SUI) can have significant morbidity, including bleeding, infection and pain. In an effort to reduce this potential morbidity, we have devised a technique which provides the same suburethral support as a standard anterior vaginal wall sling (AVWS), but without a vaginal or suprapubic incision. We describe this minimally invasive technique. Methods: From April 1998 to February 1999, 85 women underwent an incisionless suburethral fascial sling procedure. A transvaginal bone drill was used to place a bone anchor loaded with #1 prolene suture into the inferior aspect of the pubic bone on either side of the urethra. A subepithelial tunnel was created at the level of the bladder neck. A 2 x 7 cm segment of cadaveric fascia lata was placed through the subepithelial tunnel. The sutures were passed through the fascia 5mm from either edge, effectively creating a 6.0 cm sling. Finally, the sutures are tied up to the pubic symphysis.Results: Follow-up was via a self-administered questionnaire and patient interview. Recurrent SUI was noted in 2/85 (3%). New onset urge incontinence was present in 4/85 (5%). Permanent urinary retention has not occurred in either group. All procedures were performed on an outpatient basis and no operative complications occurred.Conclusions: Early results for the incisionless sling compare favorably with the long term results for the AVWS. This minimally invasive approach has thus far not been associated with any significant complications. Elimination of the vaginal and suprapubic incisions has not compromised efficacy, and appears to reduce the incidence of urge incontinence. Long term follow-up will establish the lasting efficacy of this novel surgical technique.

scholarly journals Short-, medium- and long-term results of the sling operations effectiveness and safety for urinary incontinence in women

2020 ◽  
Vol 8 (4) ◽  
pp. 80-92
Author(s):  
O. B. Loran ◽  
A. V. Seregin ◽  
Z. A. Dovlatov
Keyword(s):  
Urinary Incontinence ◽  
Surgical Treatment ◽  
Stress Urinary Incontinence ◽  
Long Term Results ◽  
Surgical Experience ◽  
Medium Term ◽  
Short Term ◽  
Mini Sling

Introduction. Sling urethropexy is considered the «gold standard» surgical treatment for stress urinary incontinence in women. However, the long-term results of such operations have not yet been fully studied.Purpose of the study. To evaluate the results of using various options for sling operations at different periods of postoperative follow-up.Materials and methods. In 698 women aged 42 - 68 years (median — 54 years) suffering stress incontinence were used 4 variants of sling operations according to the database of the S.P. Botkin City Clinical Hospital: TVT retropubic technique; transobturator technique TVT-O («inside-out»); transobturator technique TOT («outside-in»); mini sling system. The period of postoperative follow-up was 6 - 139 months (median 79 months). Evaluation of treatment results was carried out according to the following periods of postoperative follow-up: short-term (up to 1 year inclusive); mediumterm (a period from 1 to 5 years inclusive); long-term (over 5 years). The success of the treatment was determined by the criterion of the absence of urine involuntary loss during the cough test and the 1-hour pad test.Results. Treatment success in the entire sample of patients was 96.1% (671 / 698) for the short-term criterion, 93.1% (591 / 635) for the medium-term criterion and 86.2% for the long-term criterion (467 / 642). The effectiveness of short-term treatment after TVT was 97%, TVT-O — 95.8%, TOT — 96.2%, mini-sling system — 95.5%, in medium-term — 92.2%, 93.1%, 90.9% and 92.3%, respectively, for long-term — 87.1%, 86.2%, 85.2% and 85%, respectively. There were no significant differences between the indicated variants of sling operations in terms of treatment efficacy for all observation periods (p > 0.05). Intra and early postoperative complications were noted in 51 (7.3%) cases, late — in 79 (11.3%). There were no significant differences in the incidence of both categories of complications between the surgical techniques used (p > 0.05). Only surgical experience significantly affects the risk of recurrent urinary incontinence after surgery, early and late postoperative complications.Conclusions. The success of surgical treatment for stress urinary incontinence in women does not significantly depend on the type of sling surgery but depends mainly on the surgical experience. Therefore, it is advisable to use sling operations in hospitals with extensive experience in this area.

Macroplastique Implantation System for Female Stress Urinary Incontinence: Long-Term Follow-Up

2006 ◽  
Vol 20 (12) ◽  
pp. 1082-1086 ◽  
Author(s):  
José Tadeu Nunes Tamanini ◽  
Carlos Arturo Levi D'Ancona ◽  
Nelson Rodrigues Netto
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Female Stress Urinary Incontinence ◽  
Long Term Follow Up

scholarly journals Minimally invasive video-assisted thyroidectomy: a critical analysis of long-term cosmetic results using a validated tool

2019 ◽  
Vol 101 (3) ◽  
pp. 180-185 ◽  
Author(s):  
M Sahm ◽  
R Otto ◽  
M Pross ◽  
R Mantke
Keyword(s):  
Minimally Invasive ◽  
Conventional Group ◽  
Long Term Results ◽  
Cosmetic Results ◽  
Assessment Score ◽  
Conventional Thyroidectomy ◽  
Video Assisted ◽  
Scar Assessment

Introduction Since its first publication in 1997, minimally invasive video-assisted thyroidectomy (MIVAT) has developed into the predominant minimally invasive surgery of the thyroid. A major advantage over conventional thyroid surgery is the superior cosmetic result. However, there are still few data comparing the long-term cosmetic results of the two methods. This paper compares the long-term cosmetic results of the two methods, based on follow-up assessments. Methods Between 2004 and 2011, 143 preselected patients underwent a MIVAT in our department. Additionally, 134 patients underwent a conventional thyroidectomy in our hospital in 2011. A total of 117 patients from the MIVAT group and 102 patients from the conventional thyroidectomy group received follow-up assessments after 23.1 and 23.6 months, respectively, using the patient and observer scar assessment scale. Results The measurable cervical scar length averaged 1.9 cm in the MIVAT group and 3.9 cm in the conventional group (P < 0.001). Some 11.1% of the patients in the MIVAT group and 7.1% of the patients in the conventional group had developed keloid (P = 0.391). The patient scar assessment score was 10.4 for the MIVAT group compared with 9.9 for the conventional thyroidectomy group (P = 0.691) and the observer scare assessment score was 8.6 for MIVAT compared with 9.9 for conventional thyroidectomy (P = 0.011). Conclusion In the patient assessment instrument, conventional thyroidectomy had a small advantage over MIVAT in the cosmetic long-term results. This difference between the two groups was, however, not significant. Our result contradicts short-term cosmetic results of published randomized studies with improvement for MIVAT. The Observer Score demonstrates a significant advantage of the MIVAT.

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