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Low-cost transobturator vaginal tape inside-out procedure for the treatment of female stress urinary incontinence using ordinary polypropylene mesh.
Int Urogynecol J. 2015 Apr; 26(4):577-84.IU

Abstract

INTRODUCTION AND HYPOTHESIS

The aim of this study is to describe the use of ordinary polypropylene mesh and our modified helical passers through a transobturator vaginal tape inside-out technique (TVT-O) as a low-cost alternative to available commercial kits in the treatment of stress urinary incontinence (SUI) with evaluation of its long-term safety and efficacy. This is important in developing countries due to limited health care resources.

METHODS

Tailored (11 × 1.5 cm) polypropylene tape was inserted in 59 women from June 2006 to June 2009 at the Urology Department, Cairo University Hospitals as an open prospective study. SUI was diagnosed by positive cough stress test (CST) and abdominal leak point pressure (ALPP). Patients with post-void residual urine (PVRU) > 100 ml, bladder capacity < 300 ml, or neurological lesions were excluded. The Stress and Urge Incontinence and Quality of Life Questionnaire (SUIQQ), urodynamic parameters, and other variables were compared pre- versus postoperatively with paired t, Wilcoxon signed rank, McNemar, or chi-square tests.

RESULTS

The mean age was 47.47 ± 8.52 years. Twenty-one (35.6 %) patients had intrinsic sphincter deficiency (ISD). The mean operative time was 21.22 ± 4.26 min (15-30). Procedures for prolapse were done in four (6 %) patients. Complications were vaginal discharge (6 %), dyspareunia (1 %), groin pain (20 %), urinary tract infection (3 %), obstructive symptoms (1 %), accidental cut of polypropylene suture (1 %) and felt subcutaneous polypropylene sutures (3 %). We had no cases of erosions or de novo urgency. SUIQQ indices improved significantly, while urodynamic parameters showed no significant difference postoperatively. Of the patients, 54 (91 %) were cured and 3 (5 %) improved, while failure was detected in 2 (3 %) patients.

CONCLUSIONS

Our technique is safe with excellent 5-year results. It should be considered as a low-cost alternative to available commercial kits in the treatment of SUI mainly for public health systems with few financial resources.

Authors+Show Affiliations

Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt, mohammedshemy@yahoo.com.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25352073

Citation

ElSheemy, Mohammed S., et al. "Low-cost Transobturator Vaginal Tape Inside-out Procedure for the Treatment of Female Stress Urinary Incontinence Using Ordinary Polypropylene Mesh." International Urogynecology Journal, vol. 26, no. 4, 2015, pp. 577-84.
ElSheemy MS, Elsergany R, ElShenoufy A. Low-cost transobturator vaginal tape inside-out procedure for the treatment of female stress urinary incontinence using ordinary polypropylene mesh. Int Urogynecol J. 2015;26(4):577-84.
ElSheemy, M. S., Elsergany, R., & ElShenoufy, A. (2015). Low-cost transobturator vaginal tape inside-out procedure for the treatment of female stress urinary incontinence using ordinary polypropylene mesh. International Urogynecology Journal, 26(4), 577-84. https://doi.org/10.1007/s00192-014-2552-1
ElSheemy MS, Elsergany R, ElShenoufy A. Low-cost Transobturator Vaginal Tape Inside-out Procedure for the Treatment of Female Stress Urinary Incontinence Using Ordinary Polypropylene Mesh. Int Urogynecol J. 2015;26(4):577-84. PubMed PMID: 25352073.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-cost transobturator vaginal tape inside-out procedure for the treatment of female stress urinary incontinence using ordinary polypropylene mesh. AU - ElSheemy,Mohammed S, AU - Elsergany,Ragheb, AU - ElShenoufy,Ahmed, Y1 - 2014/10/29/ PY - 2014/08/20/received PY - 2014/10/13/accepted PY - 2014/10/30/entrez PY - 2014/10/30/pubmed PY - 2016/1/31/medline SP - 577 EP - 84 JF - International urogynecology journal JO - Int Urogynecol J VL - 26 IS - 4 N2 - INTRODUCTION AND HYPOTHESIS: The aim of this study is to describe the use of ordinary polypropylene mesh and our modified helical passers through a transobturator vaginal tape inside-out technique (TVT-O) as a low-cost alternative to available commercial kits in the treatment of stress urinary incontinence (SUI) with evaluation of its long-term safety and efficacy. This is important in developing countries due to limited health care resources. METHODS: Tailored (11 × 1.5 cm) polypropylene tape was inserted in 59 women from June 2006 to June 2009 at the Urology Department, Cairo University Hospitals as an open prospective study. SUI was diagnosed by positive cough stress test (CST) and abdominal leak point pressure (ALPP). Patients with post-void residual urine (PVRU) > 100 ml, bladder capacity < 300 ml, or neurological lesions were excluded. The Stress and Urge Incontinence and Quality of Life Questionnaire (SUIQQ), urodynamic parameters, and other variables were compared pre- versus postoperatively with paired t, Wilcoxon signed rank, McNemar, or chi-square tests. RESULTS: The mean age was 47.47 ± 8.52 years. Twenty-one (35.6 %) patients had intrinsic sphincter deficiency (ISD). The mean operative time was 21.22 ± 4.26 min (15-30). Procedures for prolapse were done in four (6 %) patients. Complications were vaginal discharge (6 %), dyspareunia (1 %), groin pain (20 %), urinary tract infection (3 %), obstructive symptoms (1 %), accidental cut of polypropylene suture (1 %) and felt subcutaneous polypropylene sutures (3 %). We had no cases of erosions or de novo urgency. SUIQQ indices improved significantly, while urodynamic parameters showed no significant difference postoperatively. Of the patients, 54 (91 %) were cured and 3 (5 %) improved, while failure was detected in 2 (3 %) patients. CONCLUSIONS: Our technique is safe with excellent 5-year results. It should be considered as a low-cost alternative to available commercial kits in the treatment of SUI mainly for public health systems with few financial resources. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/25352073/Low_cost_transobturator_vaginal_tape_inside_out_procedure_for_the_treatment_of_female_stress_urinary_incontinence_using_ordinary_polypropylene_mesh_ L2 - https://dx.doi.org/10.1007/s00192-014-2552-1 DB - PRIME DP - Unbound Medicine ER -