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Modified distal urethral polypropylene sling (canal transobturator tape) procedure: efficacy for persistent stress urinary incontinence after a conventional midurethral sling procedure.
Int Neurourol J. 2013 Mar; 17(1):18-23.IN

Abstract

PURPOSE

Despite reports of persistent stress urinary incontinence (SUI) in patients after the midurethral sling (MUS) procedure, there is no widely accepted definition or cause of the condition. In many cases, the mesh implanted in the previous MUS procedure has been found to have migrated proximally. The aim of this study was to evaluate the efficacy of the modified distal urethral polypropylene sling, or canal transobturator tape (TOT), procedure for persistent SUI after a conventional MUS procedure on the assumption that persistent SUI after MUS is due to the location of the sling.

METHODS

From January 2008 to April 2012, 31 female patients who underwent the canal TOT procedure presented with incontinence or lower urinary tract symptoms (LUTS) were included in this study. We identified patients who had been operated on by use of the conventional MUS procedure at other medical facilities, whose Valsalva leak pressure point was less than 120 cm-H2O by urodynamic study, and who were also diagnosed with persistent SUI. If vaginal or urethral mesh exposure was concomitant with persistent SUI, the mesh was removed completely or in part. Surgical procedures for canal TOT were identical to the original TOT procedures, except in the number and location of the vaginal incisions. Incontinence Impact Questionnaire-Short Form (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) scores were assessed preoperatively and at 3 months postoperatively.

RESULTS

There were no intraoperative or postoperative complications. Twenty-eight patients (90.3%) showed improvement in incontinence or other LUTS. Postoperative scores of the IIQ-7 (0.65±0.48) and UDI-6 (3.48±2.28) were significantly improved compared with preoperative scores (1.26±0.58 and 7.52±4.30, respectively; P<0.05).

CONCLUSIONS

Improper sling location is one of the major causes of persistent SUI after the conventional MUS procedure. Our results demonstrate that canal TOT may be an alternative method in the treatment of persistent SUI after the conventional MUS procedure.

Authors+Show Affiliations

Department of Urology, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23610707

Citation

Kim, Chang Hee, et al. "Modified Distal Urethral Polypropylene Sling (canal Transobturator Tape) Procedure: Efficacy for Persistent Stress Urinary Incontinence After a Conventional Midurethral Sling Procedure." International Neurourology Journal, vol. 17, no. 1, 2013, pp. 18-23.
Kim CH, Kim TB, Oh JK, et al. Modified distal urethral polypropylene sling (canal transobturator tape) procedure: efficacy for persistent stress urinary incontinence after a conventional midurethral sling procedure. International neurourology journal. 2013;17(1):18-23.
Kim, C. H., Kim, T. B., Oh, J. K., Yoon, S. J., Kim, K. H., & Kim, K. T. (2013). Modified distal urethral polypropylene sling (canal transobturator tape) procedure: efficacy for persistent stress urinary incontinence after a conventional midurethral sling procedure. International Neurourology Journal, 17(1), 18-23. https://doi.org/10.5213/inj.2013.17.1.18
Kim CH, et al. Modified Distal Urethral Polypropylene Sling (canal Transobturator Tape) Procedure: Efficacy for Persistent Stress Urinary Incontinence After a Conventional Midurethral Sling Procedure. International neurourology journal. 2013;17(1):18-23. PubMed PMID: 23610707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modified distal urethral polypropylene sling (canal transobturator tape) procedure: efficacy for persistent stress urinary incontinence after a conventional midurethral sling procedure. AU - Kim,Chang Hee, AU - Kim,Tae Beom, AU - Oh,Jin Kyu, AU - Yoon,Sang Jin, AU - Kim,Khae Hawn, AU - Kim,Kwang Taek, Y1 - 2013/03/31/ PY - 2013/03/07/received PY - 2013/03/26/accepted PY - 2013/4/24/entrez PY - 2013/4/24/pubmed PY - 2013/4/24/medline KW - Recurrence KW - Stress urinary incontinence KW - Suburethral slings SP - 18 EP - 23 JF - International neurourology journal VL - 17 IS - 1 N2 - PURPOSE: Despite reports of persistent stress urinary incontinence (SUI) in patients after the midurethral sling (MUS) procedure, there is no widely accepted definition or cause of the condition. In many cases, the mesh implanted in the previous MUS procedure has been found to have migrated proximally. The aim of this study was to evaluate the efficacy of the modified distal urethral polypropylene sling, or canal transobturator tape (TOT), procedure for persistent SUI after a conventional MUS procedure on the assumption that persistent SUI after MUS is due to the location of the sling. METHODS: From January 2008 to April 2012, 31 female patients who underwent the canal TOT procedure presented with incontinence or lower urinary tract symptoms (LUTS) were included in this study. We identified patients who had been operated on by use of the conventional MUS procedure at other medical facilities, whose Valsalva leak pressure point was less than 120 cm-H2O by urodynamic study, and who were also diagnosed with persistent SUI. If vaginal or urethral mesh exposure was concomitant with persistent SUI, the mesh was removed completely or in part. Surgical procedures for canal TOT were identical to the original TOT procedures, except in the number and location of the vaginal incisions. Incontinence Impact Questionnaire-Short Form (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) scores were assessed preoperatively and at 3 months postoperatively. RESULTS: There were no intraoperative or postoperative complications. Twenty-eight patients (90.3%) showed improvement in incontinence or other LUTS. Postoperative scores of the IIQ-7 (0.65±0.48) and UDI-6 (3.48±2.28) were significantly improved compared with preoperative scores (1.26±0.58 and 7.52±4.30, respectively; P<0.05). CONCLUSIONS: Improper sling location is one of the major causes of persistent SUI after the conventional MUS procedure. Our results demonstrate that canal TOT may be an alternative method in the treatment of persistent SUI after the conventional MUS procedure. SN - 2093-4777 UR - https://www.unboundmedicine.com/medline/citation/23610707/Modified_distal_urethral_polypropylene_sling__canal_transobturator_tape__procedure:_efficacy_for_persistent_stress_urinary_incontinence_after_a_conventional_midurethral_sling_procedure_ L2 - https://dx.doi.org/10.5213/inj.2013.17.1.18 DB - PRIME DP - Unbound Medicine ER -
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