scholarly journals Mini Sling (Ophira) versus Pubovaginal Sling for Treatment of Stress Urinary Incontinence: A Medium-term Follow-up

2015 ◽  
Vol 116 (3) ◽  
pp. 210-218 ◽  
Author(s):  
Farzaneh Sharifiaghdas ◽  
Mahmoodreza Nasiri ◽  
Mahboubeh Mirzaei ◽  
Behzad Narouie
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Stress Test ◽  
Pubovaginal Sling ◽  
Medium Term ◽  
Induced Stress ◽  
Significant Difference ◽  
Rectus Fascia ◽  
Mini Sling

To compare two different procedures, mid-urethral mini sling (Ophira) and autologous rectus fascia sling, according to their medium-term subjective and objective outcome and satisfaction rates in the treatment of stress urinary incontinence in women. One hundred women with the main complaint of stress urinary incontinence were randomized to be treated with either mini sling (Ophira) or autologous rectus facia pubovaginal sling. Preoperative evaluation consisted of: physical examination, blood biochemistry urine analysis and culture, urinary tract ultrasound scan, conventional multi-channel urodynamic study, cystourethroscopy, cough induced stress test and Incontinence Impact Questionnaire (IIQ). The patients were objectively and subjectively re-evaluated at 1, 3, 6 and 12 postoperative months and the last visit and the collected data of more than one year follow-up were compared with preoperative assessments. Seventy two out of one hundred patients were followed for a mean time of 13.8 ± 4.4 months (12–20 months range). Objective cure rate, according to cough-induced stress test was recorded in 88.6% and 89.2% of the mini sling (Ophira) and the rectus facia sling group respectively (P=1.0). Postoperative mean IIQ score decreased to 42.7 ± 11.4 and 50.2 ± 11.1 in the mini sling (Ophira) group versus rectus facia pubovaginal sling (P=0.007). Twenty eight (80%) and 23 (67%) patients in the mini sling (Ophira) and rectus facia pubovaginal sling were satisfied with the operation (P=0.23). There is no significant difference between the mini sling (Ophira) and autologous rectus fascia sling procedure in the treatment of stress urinary incontinence at medium-term follow-up.

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.

scholarly journals Safety and efficacy of surgical transobturator tape in the treatment of stress urinary incontinence in women - three years of follow-up

2021 ◽  
pp. 107-107
Author(s):  
Milos Pantelic ◽  
Marko Stojic ◽  
Aleksandar Curcic ◽  
Miso Dukic ◽  
Uros Kadic ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
De Novo ◽  
Elderly Women ◽  
Stress Test ◽  
Physical Exertion ◽  
Transobturator Tape ◽  
Leg Pain ◽  
Objective Stress

Introduction/Objective. Stress urinary incontinence (SUI) is defined as the complaint of involuntary loss of urine in effort or physical exertion, or on sneezing or coughing. It is a common clinical condition affecting 50% of middle-aged and elderly women. Mid-urethral slings (MUSs) are the gold standard in the treatment of SUI. The aim of this study was to investigate the success rate and complications of surgical treatment of SUI in women with transobturator tape (TOT) within the three years of follow-up. Methods. From January 2011 until January 2018, 86 women with predominantly SUI were operated by TOT procedure. In 61.6% of patients SUI was confirmed by preoperative urodynamic examination (cystometry, uroflowmetry, urethral presser profile) and in 38.4% of patients by clinical examination of stress test (cough provocation). All patients were invited for a follow-up examination 6, 12, 24 and 36 months after surgery. The result of the operation is defined as cured, improved or without success. Results. The average age was 55 (32-72) years. The most common complications were tape erosion (3.5%), incision bleeding (2.3%), transient leg pain (3.5%), dyspareunia (2.3%), vaginal erosion (3.5%) and de novo urge (5.8%). After three years of follow-up, 82.6% patients were cured. Conclusion. TOT is a safe, effective and successful procedure with 82.6% of cured patients during a three-year follow-up.

scholarly journals Transvaginal subfascial synthetic mesh sling in female stress urinary incontinence: A Novel technique

2021 ◽  
Vol 32 (1) ◽  
Author(s):  
Abdul Rouf Khawaja ◽  
Farzana Bashir ◽  
Arif Bhat ◽  
Yaser Dar ◽  
Sajad Malik ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Urge Incontinence ◽  
Stress Test ◽  
Synthetic Mesh ◽  
Female Stress Urinary Incontinence ◽  
Base Line ◽  
Sling Procedure ◽  
Novel Technique

The object of this paper is to assess the treatment outcome and overall efficacy of a novel technique of transvaginal subfascial synthetic mesh for female stress urinary incontinence. The study included 53 patients of female stress urinary incontinence managed at our institution between March 2005 and December 2015. Preoperative evaluation included a detailed history, base-line investigations and cystoscopic examination including stress test, uroflometry with residual urine was done in all cases. Lower urinary tract imaging and urodynamic evaluation was done in selected cases . patients with concomitant pelvic organ prolapse and severe BMI were excluded from the study. All patients underwent a transvaginal subfascial sling procedure under regional anesthesia. Urethral catheter was removed the day after procedure. Post procedure results were assessed in terms of improvement in stress urinary incontinence, procedure related complications, and overall satisfaction of the patient. Mean age of the patients was 43.5 years (25-63 years). All patients were multiparous. Complete resolution of symptoms in 49 patients (92.4%) while in 4 patients (7.5%) had some degree of SUI. Urinary retention in 3 (5.6%), increased frequency in 5 (9.4%) patients and urge incontinence in 2 (3.7%) One (1.8%) had mesh erosion at 3 months after the procedure. None of the patient had any sexual dysfunction on follow up. Overall success rate of the procedure was around 93%.However patients with preoperatively urge incontinence needs anticholinergics in post operative period for 1-2 months. Operative time was 30-45 minutes. Three patients (5.6%) who experience transient postoperative retention had no symptoms of SUI on follow up. Transvaginal subfascial sling is a modification of the original mid urethral sling procedure with an advantage of being less invasive, simpler to learn and achieve similar results compared to other sling procedures.

Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence

2007 ◽  
Vol 14 (12) ◽  
pp. 1076-1079 ◽  
Author(s):  
Takahiko Mitsui ◽  
Hiroshi Tanaka ◽  
Kimihiko Moriya ◽  
Hidehiro Kakizaki ◽  
Katsuya Nonomura
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pubovaginal Sling ◽  
Sling Procedure ◽  
Rectus Fascia
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