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Surgeon-tailored polypropylene mesh as a tension-free vaginal tape-obturator versus original TVT-O for the treatment of female stress urinary incontinence: a long-term comparative study.
Int Urogynecol J. 2015 Oct; 26(10):1533-40.IU

Abstract

INTRODUCTION AND HYPOTHESIS

The objective of the study was to compare the safety and efficacy of surgeon-tailored polypropylene mesh (STM) through tension-free vaginal tape-obturator (TVT-O) versus original TVT-O in the treatment of stress urinary incontinence (SUI) aiming to decrease the cost of treatment. This is important in developing countries due to limited health care resources.

METHODS

A retrospective cohort study was done at the Urology and Gynecology Departments (dual-center), Cairo University from May 2007 to June 2010. Women evaluated by cough stress test, Stress and Urge Incontinence and Quality of Life Questionnaire (SUIQQ), maximum flow rate (Qmax), and abdominal leak point pressure (ALPP) with follow-up for at least 48 months were included. Patients with post-void residual urine > 100 ml, bladder capacity < 300 ml, or impaired compliance were excluded. The effect of different factors on outcome was compared between both groups pre- and postoperatively using the paired t, Wilcoxon signed rank, McNemar, chi-square, Fisher's exact, independent t, or Mann-Whitney tests.

RESULTS

STM and TVT-O were inserted in 79 and 66 women, respectively. Intrinsic sphincter deficiency, ALPP, previous surgeries, associated urgency, urgency urinary incontinence (UUI), and prolapse were comparable in both groups. Operative duration was longer in STM by 10 min. No significant difference was found between both groups in complications (p = 0.462), cure (p = 0.654), and different indices of SUIQQ. In STM, 74 (93 %) were cured and 3 (4 %) improved, while SUI persisted in 2 (2 %) patients. In TVT-O, 59 (89 %) were cured and 4 (6 %) improved, while failure was detected in 3 (4 %) patients.

CONCLUSIONS

The 5-year outcome is comparable between STM and TVT-O. Furthermore, STM is more economical due to our resterilizable modified helical passers and the cheap polypropylene mesh.

Authors+Show Affiliations

Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt. mohammedshemy@yahoo.com.Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.Department of Gynecology and Obstetrics, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25956167

Citation

ElSheemy, Mohammed S., et al. "Surgeon-tailored Polypropylene Mesh as a Tension-free Vaginal Tape-obturator Versus Original TVT-O for the Treatment of Female Stress Urinary Incontinence: a Long-term Comparative Study." International Urogynecology Journal, vol. 26, no. 10, 2015, pp. 1533-40.
ElSheemy MS, Fathy H, Hussein HA, et al. Surgeon-tailored polypropylene mesh as a tension-free vaginal tape-obturator versus original TVT-O for the treatment of female stress urinary incontinence: a long-term comparative study. Int Urogynecol J. 2015;26(10):1533-40.
ElSheemy, M. S., Fathy, H., Hussein, H. A., Elsergany, R., & Hussein, E. A. (2015). Surgeon-tailored polypropylene mesh as a tension-free vaginal tape-obturator versus original TVT-O for the treatment of female stress urinary incontinence: a long-term comparative study. International Urogynecology Journal, 26(10), 1533-40. https://doi.org/10.1007/s00192-015-2725-6
ElSheemy MS, et al. Surgeon-tailored Polypropylene Mesh as a Tension-free Vaginal Tape-obturator Versus Original TVT-O for the Treatment of Female Stress Urinary Incontinence: a Long-term Comparative Study. Int Urogynecol J. 2015;26(10):1533-40. PubMed PMID: 25956167.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgeon-tailored polypropylene mesh as a tension-free vaginal tape-obturator versus original TVT-O for the treatment of female stress urinary incontinence: a long-term comparative study. AU - ElSheemy,Mohammed S, AU - Fathy,Hesham, AU - Hussein,Hussein A, AU - Elsergany,Ragheb, AU - Hussein,Eman A, Y1 - 2015/05/09/ PY - 2015/02/09/received PY - 2015/04/20/accepted PY - 2015/5/10/entrez PY - 2015/5/10/pubmed PY - 2016/7/9/medline KW - Cost KW - Female stress urinary incontinence KW - Polypropylene mesh KW - Surgeon-tailored mesh KW - TVT-O, TOT SP - 1533 EP - 40 JF - International urogynecology journal JO - Int Urogynecol J VL - 26 IS - 10 N2 - INTRODUCTION AND HYPOTHESIS: The objective of the study was to compare the safety and efficacy of surgeon-tailored polypropylene mesh (STM) through tension-free vaginal tape-obturator (TVT-O) versus original TVT-O in the treatment of stress urinary incontinence (SUI) aiming to decrease the cost of treatment. This is important in developing countries due to limited health care resources. METHODS: A retrospective cohort study was done at the Urology and Gynecology Departments (dual-center), Cairo University from May 2007 to June 2010. Women evaluated by cough stress test, Stress and Urge Incontinence and Quality of Life Questionnaire (SUIQQ), maximum flow rate (Qmax), and abdominal leak point pressure (ALPP) with follow-up for at least 48 months were included. Patients with post-void residual urine > 100 ml, bladder capacity < 300 ml, or impaired compliance were excluded. The effect of different factors on outcome was compared between both groups pre- and postoperatively using the paired t, Wilcoxon signed rank, McNemar, chi-square, Fisher's exact, independent t, or Mann-Whitney tests. RESULTS: STM and TVT-O were inserted in 79 and 66 women, respectively. Intrinsic sphincter deficiency, ALPP, previous surgeries, associated urgency, urgency urinary incontinence (UUI), and prolapse were comparable in both groups. Operative duration was longer in STM by 10 min. No significant difference was found between both groups in complications (p = 0.462), cure (p = 0.654), and different indices of SUIQQ. In STM, 74 (93 %) were cured and 3 (4 %) improved, while SUI persisted in 2 (2 %) patients. In TVT-O, 59 (89 %) were cured and 4 (6 %) improved, while failure was detected in 3 (4 %) patients. CONCLUSIONS: The 5-year outcome is comparable between STM and TVT-O. Furthermore, STM is more economical due to our resterilizable modified helical passers and the cheap polypropylene mesh. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/25956167/Surgeon_tailored_polypropylene_mesh_as_a_tension_free_vaginal_tape_obturator_versus_original_TVT_O_for_the_treatment_of_female_stress_urinary_incontinence:_a_long_term_comparative_study_ L2 - https://dx.doi.org/10.1007/s00192-015-2725-6 DB - PRIME DP - Unbound Medicine ER -