scholarly journals Long term outcomes of Burch colposuspension and transobturator tape and single incision needleless (DynaMesh ® - SIS minor) for the surgical treatment of female stress urinary incontinence patients who underwent combined pelvic reconstructive surgery or hysterectomy

2020 ◽  
Author(s):  
Yesim Akdemir ◽  
Fadime Dincer ◽  
Cagatay Buyukuysal ◽  
Ulku Ozmen ◽  
Muge Harma ◽  
...  

Abstract Background: Women with stress urinary incontinence (SUI) often require combined pelvic reconstructive surgeries because of shared risk factors of pelvic organ prolapse The purpose of this study is to evaluate the efficacies of Burch colposuspension, the transobturator tape (TOT), and single-incision needleless (DynaMesh®- SIS minor) procedures in patients with SUI who also underwent combined pelvic reconstructive surgery or hysterectomy. Methods: We performed this prospective cohort study that comprising 142 patients who either underwent Burch colposuspension (n:43), TOT(n:40), or SIS(n:39) procedures along with pelvic reconstructive surgery or hysterectomy between January 2010 and July 2018. During the clinical follow-up, we analyzed the objective and subjective cure rates, improvement rates, along with failure and surgical success rates of SUI surgery. We assessed quality of life and symptom severity by Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), Sandvik Severity Index (SSI), Surgical Satisfaction Questionnaire (SSQ-8), Overactive Bladder Questionnaire V8 (OAB-V8), and Patient Global Impression of Improvement (PGI-I) scale scores. The primary outcome was surgical success, which was established when there was an improvement in patients or when the patients achieved objective or subjective cure, whereas secondary outcomes included intraoperative bladder injury, sling extrusion, de novo urgency, voiding dysfunction, length of hospital stay, and patient-reported outcomes in the quality of life questionnaires. Results: Surgical success rates were higher in the Burch group than the SIS group and also higher in the TOT group than in the SIS group (88.4% vs 61.5% and 87.5% vs 61.5% respectively, p=0.003) The complaints of urinary incontinence were higher and quality of life was lower in the SIS group than in the Burch group. In terms of IIQ-7, UDI-6, OAB-V8, SSI, and SSQ-8 scores, no difference was observed between Burch and TOT groups, and TOT and SIS groups.Conclusions: Both Burch and TOT are safe and effective procedures in patients with SUI who require additional pelvic surgeries. Although the surgical outcomes of SIS procedure in patients with SUI who underwent concomitant pelvic surgeries in our study were not promising, further randomized studies are needed to clarify these observations due to unclear data.

2020 ◽  
Author(s):  
Yesim Akdemir ◽  
Fadime Dincer ◽  
Cagatay Buyukuysal ◽  
Ulku Ozmen ◽  
Muge Harma ◽  
...  

Abstract Background : Women with stress urinary incontinence (SUI) often require combined pelvic reconstructive surgeries because of shared risk factors of pelvic relaxation. The purpose of this study is to evaluate the efficacies of Burch colposuspension, the transobturator tape (TOT), and single-incision needleless (DynaMesh®- SIS minor) procedures in patients with SUI who also underwent combined pelvic reconstructive surgery or hysterectomy. Methods: We carried out this prospective cohort study that comprising 142 patients who either underwent Burch colposuspension (n:43), TOT(n:40), or SIS(n:39) procedures along with pelvic reconstructive surgery or hysterectomy between January 2010 and July 2018. During the clinical follow-up, we analyzed the objective and subjective cure rates, improvement rates, along with failure and surgical success rates of SUI surgery. We assessed quality of life and symptom severity by Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), Sandvik Severity Index (SSI), Surgical Satisfaction Questionnaire (SSQ-8), Overactive Bladder Questionnaire V8 (OAB-V8), and Patient Global Impression of Improvement (PGI-I) scale scores. The primary outcome was surgical success, which was established when there was an improvement in patients or when the patients achieved objective or subjective cure, whereas secondary outcomes included intraoperative bladder injury, sling extrusion, de novo urgency, voiding dysfunction, length of hospital stay, and patient-reported outcomes in the quality of life questionnaires. Results: Surgical success rates were higher in Burch group than SIS group and also higher in TOT group than in SIS group (88.4% vs 61.5% and 87.5% vs 61.5% respectively, p=0.003) The complaints of urinary incontinence were higher and quality of life was lower in the SIS group than in the Burch group. In terms of IIQ-7, UDI-6, OAB-V8, SSI, and SSQ-8 scores, no difference was observed between Burch and TOT groups, and TOT and SIS groups. Conclusions: Both Burch and TOT are safe and effective procedures in patients with SUI who require additional pelvic surgeries. Although the surgical outcomes of SIS procedure in patients with SUI who underwent concomitant pelvic surgeries in our study were not promising, further randomized studies are needed to clarify these observations due to unclear data.


2020 ◽  
Author(s):  
Yesim Akdemir ◽  
Fadime Dincer ◽  
Cagatay Buyukuysal ◽  
Ulku Ozmen ◽  
Muge Harma ◽  
...  

Abstract Background Women with SUI often require combined pelvic reconstructive surgery because of sharing risk factors of pelvic relaxation. The aim of this study was to evaluate the efficacy of Burch colposuspension, the transobturator tape (TOT), and single incision needleless (DynaMesh®- SIS minor) procedures in patients with SUI who also underwent combined pelvic reconstructive surgery or hysterectomy. Methods We carried out a prospective cohort study that included 142 patients who underwent Burch colposuspension (n:43), TOT(n:40), or SIS(n:39) procedures combined pelvic reconstructive surgery or hysterectomy between January 2010 and July 2018. During clinical follow-up, objective cure, subjective cure, failure and surgical success rates were analyzed. Quality of life and symptom severity were assessed by IIQ-7, UDI-6, OAB-V8, SSI, SSQ-8 and PGI-I. Primary outcome was surgical success which was defined when any of the objective cure, subjective cure or improvement has achieved and secondary outcomes were; intraoperative bladder injury, sling extrusion, de novo urgency, voiding dysfunction, length of hospital stay, and outcomes of patient reported quality of life questionnaires. Results Surgical success rate were higher in Burch group than SIS group and also higher in TOT group than SIS group (88,4% vs 61,5% and 87,5% vs 61,5% respectively, p=0,003) Urinary incontinence complaints were higher and quality of life were lower in in SIS group when compared with Burch group. No difference was seen in between Burch and TOT groups, and TOT and SIS groups in terms of IIQ-7, UDI-6, OAB-V8, SSI, and SSQ-8 scores. Conclusions Both Burch and TOT were safe and effective procedures in patients with SUI who required additional pelvic surgeries. Although surgical outcome of SIS procedure in SUI patients that had concomitant pelvic surgeries in our study was not promising, the data are not clear and further randomized studies are needed to clarify these observations.


Maturitas ◽  
2015 ◽  
Vol 81 (1) ◽  
pp. 204-205
Author(s):  
Antonio Cano ◽  
Paula Celada ◽  
Ester Ortiz ◽  
Patricia Cañete ◽  
Ana Castro

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Bulat Aytek Şık ◽  
Hanife Copur ◽  
Yılda Arzu Aba

Objective: To evaluate the clinical outcomes and the effects on quality of life of transobturator tape surgery during a 2-year follow-up period in our clinics. Methods: Eighty-seven patients with stress or mixed urinary incontinence who underwent transobturator tape surgery were included in the study conducted in Istanbul. Taksim. Training. and Research Hospital Gynecology and Obstetrics Clinic, between 2011 and 2013. The patients’ demographic features, incontinence questionnaires, quality of life scores [Incontinence Impact Questionnaire (IIQ-7) and urinary distress inventories (UDI-6)], examination findings, urodynamic results, stress tests, Q tip tests, number of daily pads, ultrasonography, surgery, and cystoscopy results were recorded. Patients were evaluated 23-27 months (mean: 25.40±1.31 months) after their discharge in terms of symptoms, quality of life scores, urodynamic findings, complications, and stress test. Results: Sixty-three (72.4%) patients had stress incontinence and 24 (27.6%) patients had mixed urinary incontinence. No perioperative complications were observed in our study. After a follow-up period of two years, a significant improvement was detected in the IIQ-7 and UDI-6 questionnaires when compared with the preoperative period. Moreover, the objective cure rate was found as 88.5% (n=77). De novo urge incontinence was obtained in 5.7% (n=5) of patients and was treated with anticholinergics. Perineal pain was present in 3 (3.44%) patients and was treated with analgesics and cold packs. In 2 (2.29%) patients, vaginal mesh erosion was detected and full recovery was achieved with an excision. Urinary retention and bladder perforation was not seen in any patients. Conclusion: Our study revealed a high objective cure rate, and an improvement in symptoms and quality of life with the transobturator tape operation. How to cite this:Sik BA, Copur H, Yilda Arzu ABA. The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years’ follow-up. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.603 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2014 ◽  
Vol 61 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Milan Potic ◽  
Ivan Ignjatovic ◽  
Dragoslav Basic

Background: Stress urinary incontinence (SUI) is managed with both TVT and TOT. The TVT route of placement could result in a higher complication rate. The aim of this study is to analyze and compare outcomes and complications of TVT and TOT in SUI treatment. Methods: Prospective study in 64 women with isolated SUI was validated through Urogenital Distress Inventory (UDI-6), Incontinence Impact questionnaire (IIQ-7) and International Continence Impact Questionnaire (ICIQ5-SF). Intraoperative and postoperative complications were noted. Patients were considered cured when negative on stress test and with no need for additional surgery during follow up, after one and three months. Results: The cure rates for both TVT 26/30 (86,6%) and TOT 30/34 (88,2) were comparable. Higher rates of bleeding, bladder perforations, pain and dyspareunia are recorded in TVT group. Quality of life graded on the questionnaire basis proved significant improvement in both procedures. Conclusion: Both TVT and TOT have comparable cure results in the treatment of SUI. The TOT is equally effective in the SUI treatment with significantly lower complication incidence.


2020 ◽  
Vol 7 (1) ◽  
pp. 40-43
Author(s):  
Tahereh Poordast ◽  
Elham Askari ◽  
Fatemeh Sadat Najib ◽  
Shaghayegh Moradialamdarloo ◽  
Najmeh Naghizadeh

Background and aims: Stress urinary incontinence is one of the most common diseases which can reduce the quality of life in women. Urodynamic test is a common method of diagnosis of this disease. This study is designed for investigating the necessity of urodynamic test in patients with urinary stress incontinency before transobturator tape (TOT) surgery. Urodynamic test before surgery can affect the quality of life in patients. Methods: This study was a randomized clinical trial. The sample size was 48 patients divided into two groups of 24 women in January 2018. Women with urinary incontinence complaints were randomly divided into two groups. For the first group, the urodynamic test was done. Both groups were evaluated one month and six months after TOT surgery based on the results of the I-QOL questionnaire. Results: The mean I-QOL score was 83.9±3.3 in questionnaire group and 81.6±4.6 in urodynamic group one month after surgery with no statistically significant (P=0.052) difference. The quality of life score after 6 months was 87.2±4 in the questionnaire group and 85.4±3 in the urodynamic group with no statistically significant differences with each other (P=0.084). Conclusion: In this study, the urodynamic test only had additional information related to lower urinary tract symptoms and it did not have effects on improving the outcome of the surgery. The test only imposes economic burden. Therefore, the urodynamic test is not required before surgery in patients with urinary stress incontinence


2021 ◽  
Vol 72 (1) ◽  
pp. 43-52
Author(s):  
Florencio Manuel Marín-Martínez ◽  
Julián Oñate-Celdrán ◽  
Olimpia Molina-Hernández ◽  
Miriam Artes-Artes ◽  
Emny Rochelle Bobadilla-Romero ◽  
...  

Objective: Describe the medium-term safety of the tension free vaginal tape obturator (TVT-O) procedure in terms of complications, cure and changes in quality of life (QoL) after the surgery. Materials and methods: Descriptive historical cohort that included women over 18 years of age who underwent TVT-O due to objectively proven stress urinary incontinence, urethral hypermobility or mixed urinary incontinence in which the stress component predominated, confirmed on urodynamic testing between July 2013-April 2017, in a reference hospital located in the city of Murcia Spain. Women with previous anti-incontinence surgery, concomitant vaginal surgery and planning pregnancy were excluded. Follow-up was determined for each patient based on the time elapsed between surgery and the time when the research protocol was applied. Complications were stratified according to the modified Clavien-Dindo classification; also we evaluated subjective cure rate, quality of life using the ICIQ-SF score, before and after surgery. Results: The mean age was 52.6 (SD± 10.5) years and 80.1% of patients were at least overweight. The incidence of complications at 12 months was: 8.3% (12/144). We did not detect complications after this period in the followed patients at 24, 36 and 48 months. The subjective cure determined at 12, 24, 36 and 48 months was 62.5% (90/144), 59.09% (55/88), 50.81% (31/61) and 50% (7/14), respectively. There was a significant improvement in quality of life, as determined by the ICQ-SF mean score before and after surgery (13.76[6,34] vs 3.84[5.76]; p<0.05). Conclusions: The TVT-O surgery is a safe therapy associated with a low complication incidence at 12 months, an acceptable subjective cure rate in stress urinary incontinence, and quality-of-life improvement. Classifications of complications related to the insertion of the prosthesis and of those inherent to surgery, such as urinary tract infection, are required.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Anna Byszewska ◽  
Anselm Jünemann ◽  
Marek Rękas

Purpose. To compare phacocanaloplasty (PC) and phaco-non-penetrating deep sclerectomy (PDS). Methods. 75 patients with uncontrolled glaucoma and cataract were randomized for PC (37 eyes) or PDS (38 eyes). Intraocular pressure (IOP) and number of medications (meds) were prospectively evaluated. Follow-up examinations were performed on days 1 and 7 and after 1, 3, 6, 12, 18, and 24 months. Surgical success was calculated. Complications and postoperative interventions were noted. Quality of life (QoL) was analyzed. Results. Preoperatively, mean IOP and meds were comparable (P>0.05). After 24 months, IOP significantly decreased in PC from 19.4 ± 5.9 mmHg (2.6 ± 0.9 meds) to 13.8 ± 3.3 mmHg (0.5 ± 0.9 meds) and in PDS from 19.7 ± 5.4 mmHg (2.9 ± 0.9 meds) to 15.1 ± 2.9 mmHg (1.1 ± 1.2 meds). Statistically lower IOP was observed in PC in the 6th month and persisted until 24 months (P<0.05). No difference was found in meds (except for month 18, in which less drugs were used in PC (P=0.001)) or success rates (P>0.05). The most frequent complication in PC was transient hyphema (46%), in PDS bleb fibrosis (24%). PC patients during postoperative period required only goniopuncture (22% of subjects), whereas PDS patients required, in order to maintain subconjuctival outflow, subconjunctival 5-fluorouracil injections in 95% of cases (median = 3), suture lysis (34%), needling (24%), and goniopuncture (37%). NEI VFQ-25 mean composite score for PC was 78.04 ± 24.36 points and for PDS 74.29 ± 24.45 (P=0.136). α Cronbach’s correlation coefficient was 0.913. Conclusions. PC leads to a more effective decrease in IOP than PDS in midterm observation with similar safety profiles. PDS patients required a vast number of additional procedures in contrast to PC patients, but this fact did not influence QoL.


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