Transvaginal subfascial synthetic mesh sling in female stress urinary incontinence: A 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.

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Mesh Cutting after Midurethral Sling Procedure in Female Stress Urinary Incontinence: 1 Year Follow-up

Journal of the Korean Continence Society ◽

10.5213/jkcs.2007.11.1.59 ◽

2007 ◽

Vol 11 (1) ◽

pp. 59

Author(s):

Dong Hwan Lee ◽

Jo Un Jung ◽

Hong Jin Suh

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Midurethral Sling ◽

Female Stress Urinary Incontinence ◽

Sling Procedure

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Vaginocutaneous fistula: A rare long-term complication of transobturator tape procedure for stress urinary incontinence

Urologia Journal ◽

10.1177/0391560320947260 ◽

2020 ◽

pp. 039156032094726

Author(s):

Uygar Micoogullari ◽

Cem Yucel ◽

Volkan Ulker ◽

Mehmet Zeynel Keskin ◽

Orcun Celik

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Transobturator Tape ◽

Female Stress Urinary Incontinence ◽

Complication Rates ◽

Sling Procedure ◽

Long Term Follow Up ◽

Delayed Complications

Introduction: Synthetic mid-urethral slings are currently the most common performed surgical procedure for the treatment of female stress urinary incontinence. The transobturator mid-urethral sling technique has been widely accepted owing to its high success and low complication rates. Although complications are rarely seen, it may cause significant morbidity. Case presentation: We report a case of vaginocutaneous fistula following transobturator mid-urethral sling procedure and a successful reconstruction with transvaginal sling excision and fistula closure. Conclusion: Vaginocutaneous fistula is a known but rarely seen long-term complication of transobturator tape. With an increased use of mesh, various delayed complications can be seen in the long-term follow-up. This case showed us the need for longer and detailed studies that evaluate the effectiveness and safety of the transobturator tape procedure.

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Trans-Oturator-Tape (T.O.T.) "outside-in" approach in surgical treatment of female stress urinary incontinence

Acta chirurgica iugoslavica ◽

10.2298/aci1401069j ◽

2014 ◽

Vol 61 (1) ◽

pp. 69-72

Author(s):

M. Jovanovic ◽

Zoran Dzamic ◽

Miodrag Acimovic ◽

Boris Kajmakovic ◽

Tomislav Pejcic

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Stress Test ◽

Female Stress Urinary Incontinence ◽

Minimally Invasive Surgical Procedure ◽

Full Bladder ◽

Minimally Invasive Surgical ◽

Cough Stress Test ◽

Safe Technique

Objective: The aim of the study was to analyzed the efficacy and safety of a minimally invasive surgical procedure using the Trans-Obturator-Tape with "outside-in" approach for treatment female stress urinary incontinence. Patients and Methods: 171 women with stress urinary incontinence (SUI) associated with urethral hypermobility, underwent the T.O.T. procedure (March 2010 to January 2014). 27 patients were previously operated for incontinence. Mean age was 59 years (37-80). 6 patients were having mixed incontinence, and 51 had SUI with urgencies. A non-elastic, polypropylene tape was placed under the mid-urethra. The surgical placement technique utilises a trans - obturator percutaneous approach. All patients underwent post-operative clinical examination, cough-stress test (full bladder), uroflowmetry, and post-voiding residual assessment. Results: Mean follow-up was 22 months (4-45). At 12 months follow-up 91,2% of the patients were completely cured. The overall peri-operative complication rate was 6,4% with no vascular, nerve or bowel injury. 5 patients (2,9%) had post-operative urinary retention. Conclusion: The present study confirms the results obtained by the instigator of the technique, E. Delorme, and allows us to consider T.O.T. as an effective and safe technique for the treatment of female stress urinary incontinence.

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