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Prospective randomized comparison of the transobturator mid-urethral sling with the single-incision sling among women with stress urinary incontinence: 1-year follow-up study.
Int Urogynecol J. 2016 May; 27(5):791-6.IU

Abstract

INTRODUCTION AND HYPOTHESIS

The objective was to compare the efficacy and safety of an innovative single-incision sling (SIS) with the inside-out transobturator sling (TOT) in the treatment of female stress urinary incontinence (SUI).

METHODS

A prospective randomized trial was performed in a tertiary referral urogynecology center from January 2012 to December 2013. The study included women with pure urodynamic SUI. Patients were randomized to either the SIS or the TOT anti-incontinence procedure. Surgery duration, blood loss, and groin pain scores were recorded for each patient. The 1-year follow-up visit included objective and subjective cure parameters, postoperative de novo urgency, complications, and the impact on the patient's life quality.

RESULTS

Of 285 patients assessed for eligibility, a total of 93 patients (32.6 %) were randomized into TOT (n = 48) and SIS groups (n = 45). There were no significant differences in either operating time or blood loss. A statistically significant difference between the two groups was found in pain scores three (5.6 ± 1.8 vs 3.1 ± 2.1, p < 0.001) and 12 h postoperatively (3.8 ± 1.7 vs 2.1 ± 1.7, p < 0.001). After 1 year, there were no significant differences between the TOT and SIS groups in objective cure rates (87.0 % vs 90.9 %; p = 0.399) or patient-reported success rates (91.3 % vs 93.2 %; p = 0.999). Incidence of postoperative de novo urgency did not differ between TOT and SIS patients. Both groups registered a significant improvement in quality of life.

CONCLUSIONS

The Ophira SIS procedure has 1-year success rates comparable to standard TOT with significantly less groin pain in the early postoperative period. Both methods were safe and effective in terms of postoperative urgency and life quality improvement.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Masaryk University Medical School, Obilni trh 11, 602 00, Brno, Czech Republic.Department of Obstetrics and Gynecology, Brno University Hospital and Masaryk University Medical School, Jihlavska 20, 625 00, Brno, Czech Republic. martin.huser@gmail.com.Department of Obstetrics and Gynecology, Brno University Hospital and Masaryk University Medical School, Jihlavska 20, 625 00, Brno, Czech Republic.Department of Obstetrics and Gynecology, Brno University Hospital and Masaryk University Medical School, Jihlavska 20, 625 00, Brno, Czech Republic.Department of Obstetrics and Gynecology, Brno University Hospital and Masaryk University Medical School, Jihlavska 20, 625 00, Brno, Czech Republic.Department of Paediatric Anesthesiology and Intensive Care, Brno University Hospital and Masaryk University Medical School, Cernopolni 9, 662 63, Brno, Czech Republic.Institute of Biostatistics and Analyses of Masaryk University Medical School, Kamenice 126/3, 625 00, Brno, Czech Republic.Department of Obstetrics and Gynecology, Brno University Hospital and Masaryk University Medical School, Jihlavska 20, 625 00, Brno, Czech Republic.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26630947

Citation

Jurakova, Michaela, et al. "Prospective Randomized Comparison of the Transobturator Mid-urethral Sling With the Single-incision Sling Among Women With Stress Urinary Incontinence: 1-year Follow-up Study." International Urogynecology Journal, vol. 27, no. 5, 2016, pp. 791-6.
Jurakova M, Huser M, Belkov I, et al. Prospective randomized comparison of the transobturator mid-urethral sling with the single-incision sling among women with stress urinary incontinence: 1-year follow-up study. Int Urogynecol J. 2016;27(5):791-6.
Jurakova, M., Huser, M., Belkov, I., Janku, P., Hudecek, R., Stourac, P., Jarkovsky, J., & Ventruba, P. (2016). Prospective randomized comparison of the transobturator mid-urethral sling with the single-incision sling among women with stress urinary incontinence: 1-year follow-up study. International Urogynecology Journal, 27(5), 791-6. https://doi.org/10.1007/s00192-015-2895-2
Jurakova M, et al. Prospective Randomized Comparison of the Transobturator Mid-urethral Sling With the Single-incision Sling Among Women With Stress Urinary Incontinence: 1-year Follow-up Study. Int Urogynecol J. 2016;27(5):791-6. PubMed PMID: 26630947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective randomized comparison of the transobturator mid-urethral sling with the single-incision sling among women with stress urinary incontinence: 1-year follow-up study. AU - Jurakova,Michaela, AU - Huser,Martin, AU - Belkov,Ivan, AU - Janku,Petr, AU - Hudecek,Robert, AU - Stourac,Petr, AU - Jarkovsky,Jiri, AU - Ventruba,Pavel, Y1 - 2015/12/02/ PY - 2015/09/08/received PY - 2015/11/15/accepted PY - 2015/12/4/entrez PY - 2015/12/4/pubmed PY - 2017/1/14/medline KW - Efficacy KW - Mid-urethral sling KW - Patient-reported outcomes KW - Randomized controlled trial KW - Single-incision sling KW - Stress urinary incontinence SP - 791 EP - 6 JF - International urogynecology journal JO - Int Urogynecol J VL - 27 IS - 5 N2 - INTRODUCTION AND HYPOTHESIS: The objective was to compare the efficacy and safety of an innovative single-incision sling (SIS) with the inside-out transobturator sling (TOT) in the treatment of female stress urinary incontinence (SUI). METHODS: A prospective randomized trial was performed in a tertiary referral urogynecology center from January 2012 to December 2013. The study included women with pure urodynamic SUI. Patients were randomized to either the SIS or the TOT anti-incontinence procedure. Surgery duration, blood loss, and groin pain scores were recorded for each patient. The 1-year follow-up visit included objective and subjective cure parameters, postoperative de novo urgency, complications, and the impact on the patient's life quality. RESULTS: Of 285 patients assessed for eligibility, a total of 93 patients (32.6 %) were randomized into TOT (n = 48) and SIS groups (n = 45). There were no significant differences in either operating time or blood loss. A statistically significant difference between the two groups was found in pain scores three (5.6 ± 1.8 vs 3.1 ± 2.1, p < 0.001) and 12 h postoperatively (3.8 ± 1.7 vs 2.1 ± 1.7, p < 0.001). After 1 year, there were no significant differences between the TOT and SIS groups in objective cure rates (87.0 % vs 90.9 %; p = 0.399) or patient-reported success rates (91.3 % vs 93.2 %; p = 0.999). Incidence of postoperative de novo urgency did not differ between TOT and SIS patients. Both groups registered a significant improvement in quality of life. CONCLUSIONS: The Ophira SIS procedure has 1-year success rates comparable to standard TOT with significantly less groin pain in the early postoperative period. Both methods were safe and effective in terms of postoperative urgency and life quality improvement. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/26630947/Prospective_randomized_comparison_of_the_transobturator_mid_urethral_sling_with_the_single_incision_sling_among_women_with_stress_urinary_incontinence:_1_year_follow_up_study_ DB - PRIME DP - Unbound Medicine ER -