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Is the fixation of single incision TVT-S tape as good as that of transobturator tape? An ultrasound study of randomized trial results.
Int Urogynecol J. 2020 Jun 24 [Online ahead of print]IU

Abstract

INTRODUCTION

TVT-Secur (TVT-S) was the first single-incision sling available on the market and was soon found to have less efficacy than mid-urethral slings. Our aim was to assess the position and tape descent following TVT-O and TVT-S H in a U procedure and, based on this evaluation, to find the possible reason for lower TVT-S surgery efficacy.

METHODS

We conducted an ultrasound study of a randomised trial with a 3-year follow-up that took place between 2007 and 2009 and included 197 women with urodynamic stress urinary incontinence. Of these, 67 were allocated to receive the TVT-O procedure, 64 to TVT-S in the H position, and 65 in the U position. Patients underwent a complete urogynaecological and ultrasound examination. The positions of the bladder neck and the tape after surgery were assessed and the data obtained compared between groups.

RESULTS

Our primary study showed a significantly higher rate of positive stress tests in the TVT-S groups compared to the TVT-O group. After surgery, there was no difference between the position of the tape at rest and at maximal Valsalva between the groups. In TVT-O patients, the mean length of the upper tape margin descent increased from 6 mm on the 1st day after surgery to 9 mm 3 months after surgery and remained stable afterwards. For TVT-S patients, there was a further increase of up to 15 mm in tape descent after 3 months.

CONCLUSIONS

Our results show that the lower efficacy of TVT-S might be due to inadequate fixation and increasing tape descent.

Authors+Show Affiliations

Department of General Gynaecology and Urogynaecology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia.Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Nové Měst, Czech Republic.Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Nové Měst, Czech Republic.Department of General Gynaecology and Urogynaecology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia.Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Nové Měst, Czech Republic.Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Nové Měst, Czech Republic. masata@volny.cz.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32583011

Citation

Serdinsek, Tamara, et al. "Is the Fixation of Single Incision TVT-S Tape as Good as That of Transobturator Tape? an Ultrasound Study of Randomized Trial Results." International Urogynecology Journal, 2020.
Serdinsek T, Martan A, Svabik K, et al. Is the fixation of single incision TVT-S tape as good as that of transobturator tape? An ultrasound study of randomized trial results. Int Urogynecol J. 2020.
Serdinsek, T., Martan, A., Svabik, K., But, I., Kolek, P., & Masata, J. (2020). Is the fixation of single incision TVT-S tape as good as that of transobturator tape? An ultrasound study of randomized trial results. International Urogynecology Journal. https://doi.org/10.1007/s00192-020-04390-6
Serdinsek T, et al. Is the Fixation of Single Incision TVT-S Tape as Good as That of Transobturator Tape? an Ultrasound Study of Randomized Trial Results. Int Urogynecol J. 2020 Jun 24; PubMed PMID: 32583011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is the fixation of single incision TVT-S tape as good as that of transobturator tape? An ultrasound study of randomized trial results. AU - Serdinsek,Tamara, AU - Martan,Alois, AU - Svabik,Kamil, AU - But,Igor, AU - Kolek,Petr, AU - Masata,Jaromir, Y1 - 2020/06/24/ PY - 2020/03/06/received PY - 2020/06/09/accepted PY - 2020/6/26/entrez KW - Single-incision slings KW - Stress urinary incontinence KW - TVT-S KW - Trans-obturator tape KW - Treatment failure KW - Ultrasound study JF - International urogynecology journal JO - Int Urogynecol J N2 - INTRODUCTION: TVT-Secur (TVT-S) was the first single-incision sling available on the market and was soon found to have less efficacy than mid-urethral slings. Our aim was to assess the position and tape descent following TVT-O and TVT-S H in a U procedure and, based on this evaluation, to find the possible reason for lower TVT-S surgery efficacy. METHODS: We conducted an ultrasound study of a randomised trial with a 3-year follow-up that took place between 2007 and 2009 and included 197 women with urodynamic stress urinary incontinence. Of these, 67 were allocated to receive the TVT-O procedure, 64 to TVT-S in the H position, and 65 in the U position. Patients underwent a complete urogynaecological and ultrasound examination. The positions of the bladder neck and the tape after surgery were assessed and the data obtained compared between groups. RESULTS: Our primary study showed a significantly higher rate of positive stress tests in the TVT-S groups compared to the TVT-O group. After surgery, there was no difference between the position of the tape at rest and at maximal Valsalva between the groups. In TVT-O patients, the mean length of the upper tape margin descent increased from 6 mm on the 1st day after surgery to 9 mm 3 months after surgery and remained stable afterwards. For TVT-S patients, there was a further increase of up to 15 mm in tape descent after 3 months. CONCLUSIONS: Our results show that the lower efficacy of TVT-S might be due to inadequate fixation and increasing tape descent. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/32583011/Is_the_fixation_of_single_incision_TVT-S_tape_as_good_as_that_of_transobturator_tape_An_ultrasound_study_of_randomized_trial_results L2 - https://dx.doi.org/10.1007/s00192-020-04390-6 DB - PRIME DP - Unbound Medicine ER -
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