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Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery.
Taiwan J Obstet Gynecol. 2018 Aug; 57(4):528-531.TJ

Abstract

OBJECTIVE

A midurethral sling is the gold standard surgical treatment for stress urinary incontinence (SUI), however a lower success rate has been reported in the treatment of SUI after pelvic organ prolapse surgery. The aim of this study was to compare the success rates, quality of life, and complications with treatment using tension-free vaginal tape (TVT) and transobturator tape (TOT) in these patients.

MATERIALS AND METHODS

We enrolled patients who had symptomatic SUI after anterior vaginal mesh repair who underwent either TVT or TOT surgery. Successfully cure was defined as the absence of urinary leakage in a stress test during filling cystometry, and a negative cough test. Quality of life was evaluated using the short form of the Urinary Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7).

RESULTS

We included 50 patients in the TOT group and 37 patients in the TVT group, with a median follow-up of 18.5 months. The TVT group had a significantly higher success rate than the TOT group (88% vs. 60%, p = 0.036), while there was no statistically significant difference in de novo detrusor overactivity (30% vs. 9%, p = 0.090). There was also no significant difference in postoperative quality of life (UDI-6, 5.9 ± 7.9 vs. 5.0 ± 5.9, p = 0.639; IIQ-7, 5.2 ± 12.5 vs. 4.3 ± 9.7, p = 0.766). The TVT group had a longer operative time (p < 0.001) and hospital stay (p = 0.004), however the TOT group required more repeat surgeries for recurrent SUI (p = 0.045).

CONCLUSION

Retropubic TVT is a more effective surgical option than TOT in women with SUI after vaginal mesh repair.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan.Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan.Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan. Electronic address: huihsuan1220@gmail.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30122572

Citation

Lin, Lim, et al. "Comparison Between Tension-free Vaginal Tape and Transobturator Tape in Treating Stress Urinary Incontinence After Vaginal Mesh Surgery." Taiwanese Journal of Obstetrics & Gynecology, vol. 57, no. 4, 2018, pp. 528-531.
Lin L, Huang MC, Su TH, et al. Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery. Taiwan J Obstet Gynecol. 2018;57(4):528-531.
Lin, L., Huang, M. C., Su, T. H., & Lau, H. H. (2018). Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery. Taiwanese Journal of Obstetrics & Gynecology, 57(4), 528-531. https://doi.org/10.1016/j.tjog.2018.06.008
Lin L, et al. Comparison Between Tension-free Vaginal Tape and Transobturator Tape in Treating Stress Urinary Incontinence After Vaginal Mesh Surgery. Taiwan J Obstet Gynecol. 2018;57(4):528-531. PubMed PMID: 30122572.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery. AU - Lin,Lim, AU - Huang,Ming-Chao, AU - Su,Tsung-Hsien, AU - Lau,Hui-Hsuan, PY - 2017/06/30/accepted PY - 2018/8/21/entrez PY - 2018/8/21/pubmed PY - 2018/12/18/medline KW - Complications KW - Quality of life KW - Retropubic sling KW - Stress urinary incontinence KW - Transobturator sling SP - 528 EP - 531 JF - Taiwanese journal of obstetrics & gynecology JO - Taiwan J Obstet Gynecol VL - 57 IS - 4 N2 - OBJECTIVE: A midurethral sling is the gold standard surgical treatment for stress urinary incontinence (SUI), however a lower success rate has been reported in the treatment of SUI after pelvic organ prolapse surgery. The aim of this study was to compare the success rates, quality of life, and complications with treatment using tension-free vaginal tape (TVT) and transobturator tape (TOT) in these patients. MATERIALS AND METHODS: We enrolled patients who had symptomatic SUI after anterior vaginal mesh repair who underwent either TVT or TOT surgery. Successfully cure was defined as the absence of urinary leakage in a stress test during filling cystometry, and a negative cough test. Quality of life was evaluated using the short form of the Urinary Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). RESULTS: We included 50 patients in the TOT group and 37 patients in the TVT group, with a median follow-up of 18.5 months. The TVT group had a significantly higher success rate than the TOT group (88% vs. 60%, p = 0.036), while there was no statistically significant difference in de novo detrusor overactivity (30% vs. 9%, p = 0.090). There was also no significant difference in postoperative quality of life (UDI-6, 5.9 ± 7.9 vs. 5.0 ± 5.9, p = 0.639; IIQ-7, 5.2 ± 12.5 vs. 4.3 ± 9.7, p = 0.766). The TVT group had a longer operative time (p < 0.001) and hospital stay (p = 0.004), however the TOT group required more repeat surgeries for recurrent SUI (p = 0.045). CONCLUSION: Retropubic TVT is a more effective surgical option than TOT in women with SUI after vaginal mesh repair. SN - 1875-6263 UR - https://www.unboundmedicine.com/medline/citation/30122572/Comparison_between_tension_free_vaginal_tape_and_transobturator_tape_in_treating_stress_urinary_incontinence_after_vaginal_mesh_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1028-4559(18)30126-8 DB - PRIME DP - Unbound Medicine ER -