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Five-year clinical and imaging outcomes of primary transobturator midurethral sling procedures for uncomplicated urodynamic stress incontinence.
Maturitas. 2020 Aug; 138:42-50.M

Abstract

OBJECTIVES

To report 5-year clinical and imaging outcomes of primary transoburator midurethral sling (TOT) procedures for uncomplicated urodynamic stress incontinence (USI).

MATERIALS AND METHODS

We retrospectively investigated the data of 136 women who underwent primary TOT procedures for uncomplicated USI. All women received preoperative as well as 1-year and 5-year postoperative assessments comprising clinical interview, pelvic examination, and introital four-dimensional (4D) ultrasound. The primary outcome was stress urinary incontinence (SUI), defined as the report of SUI in patient interview, a positive response to item 3 of the short form of the Urogenital Distress Inventory (UDI-6), or a positive cough stress test and negative dysuria or urinalysis. Secondary outcomes included SUI severity, SUI bother, scores on the short forms of the UDI-6 and Incontinence Impact Questionnaire (IIQ-7), rates of de novo overactive bladder (OAB) symptoms, de novo voiding dysfunction, groin/thigh pain, and sling exposure, as well as ultrasound manifestations of bladder neck, midurethra, and sling.

RESULTS

At 1 and 5 years, rates for SUI (7.4% vs 8.8%, P = 0.824), de novo OAB symptoms (4.4% vs 5.1%, P = 1.000), de novo voiding dysfunction (11.2% vs 10.3%, P = 1.000), groin/thigh pain (3.7% vs 0.7%, P = 0.216), and sling exposure (2.2% vs 0.0%, P = 0.246) were similar. Scores on the UDI-6 and IIQ-7 were significantly decreased postoperatively. Sling location and a more cranioventral midurethral location were sustained during follow-up.

CONCLUSIONS

For uncomplicated USI, TOT has good and sustained clinical and imaging outcomes, though a notable rate of de novo voiding dysfunction.

Authors+Show Affiliations

Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan, Republic of China; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China. Electronic address: huangwc.galaxy@hotmail.com.Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China.Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China; Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China; Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32631587

Citation

Huang, Wen-Chen, et al. "Five-year Clinical and Imaging Outcomes of Primary Transobturator Midurethral Sling Procedures for Uncomplicated Urodynamic Stress Incontinence." Maturitas, vol. 138, 2020, pp. 42-50.
Huang WC, Yang JM, Chen HF. Five-year clinical and imaging outcomes of primary transobturator midurethral sling procedures for uncomplicated urodynamic stress incontinence. Maturitas. 2020;138:42-50.
Huang, W. C., Yang, J. M., & Chen, H. F. (2020). Five-year clinical and imaging outcomes of primary transobturator midurethral sling procedures for uncomplicated urodynamic stress incontinence. Maturitas, 138, 42-50. https://doi.org/10.1016/j.maturitas.2020.05.005
Huang WC, Yang JM, Chen HF. Five-year Clinical and Imaging Outcomes of Primary Transobturator Midurethral Sling Procedures for Uncomplicated Urodynamic Stress Incontinence. Maturitas. 2020;138:42-50. PubMed PMID: 32631587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Five-year clinical and imaging outcomes of primary transobturator midurethral sling procedures for uncomplicated urodynamic stress incontinence. AU - Huang,Wen-Chen, AU - Yang,Jenn-Ming, AU - Chen,Hsin-Fu, Y1 - 2020/05/19/ PY - 2020/02/03/received PY - 2020/04/24/revised PY - 2020/05/08/accepted PY - 2020/7/8/entrez KW - de novo voiding dysfunction KW - midurethra KW - stress urinary incontinence KW - transobturator midurethral sling KW - urodynamic stress incontinence SP - 42 EP - 50 JF - Maturitas JO - Maturitas VL - 138 N2 - OBJECTIVES: To report 5-year clinical and imaging outcomes of primary transoburator midurethral sling (TOT) procedures for uncomplicated urodynamic stress incontinence (USI). MATERIALS AND METHODS: We retrospectively investigated the data of 136 women who underwent primary TOT procedures for uncomplicated USI. All women received preoperative as well as 1-year and 5-year postoperative assessments comprising clinical interview, pelvic examination, and introital four-dimensional (4D) ultrasound. The primary outcome was stress urinary incontinence (SUI), defined as the report of SUI in patient interview, a positive response to item 3 of the short form of the Urogenital Distress Inventory (UDI-6), or a positive cough stress test and negative dysuria or urinalysis. Secondary outcomes included SUI severity, SUI bother, scores on the short forms of the UDI-6 and Incontinence Impact Questionnaire (IIQ-7), rates of de novo overactive bladder (OAB) symptoms, de novo voiding dysfunction, groin/thigh pain, and sling exposure, as well as ultrasound manifestations of bladder neck, midurethra, and sling. RESULTS: At 1 and 5 years, rates for SUI (7.4% vs 8.8%, P = 0.824), de novo OAB symptoms (4.4% vs 5.1%, P = 1.000), de novo voiding dysfunction (11.2% vs 10.3%, P = 1.000), groin/thigh pain (3.7% vs 0.7%, P = 0.216), and sling exposure (2.2% vs 0.0%, P = 0.246) were similar. Scores on the UDI-6 and IIQ-7 were significantly decreased postoperatively. Sling location and a more cranioventral midurethral location were sustained during follow-up. CONCLUSIONS: For uncomplicated USI, TOT has good and sustained clinical and imaging outcomes, though a notable rate of de novo voiding dysfunction. SN - 1873-4111 UR - https://www.unboundmedicine.com/medline/citation/32631587/Five-year_clinical_and_imaging_outcomes_of_primary_transobturator_midurethral_sling_procedures_for_uncomplicated_urodynamic_stress_incontinence L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-5122(20)30262-0 DB - PRIME DP - Unbound Medicine ER -
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