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A modified mid-urethral sling technique for stress urinary incontinence: Three-year results of a prospective randomized trial in comparison with original transobturator tape procedure

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Abstract

Introduction and hypothesis

Stress urinary incontinence (SUI) is the most common subtype of urinary incontinence, which causes many social, psychological, and economic problems. Mid-urethral sling (MUS) surgery is popular worldwide for the treatment of SUI. We aimed to define a new modified mid-urethral sling technique (mMUS) in SUI treatment and to compare it with transobturator tape (TOT) surgery in terms of safety and efficiency.

Methods

A prospective, randomized study was planned with 126 women suffering from SUI. The patients were randomly divided into two groups, TOT and mMUS. In mMUS, the obturator membrane was not perforated. The objective and subjective symptoms, pain, quality-of-life measures, and side effect profiles were assessed in a 3-year follow-up. The visual analogue scale (VAS) was used for postoperative pain assessment. The International Consultation on Incontinence Questionnaire–Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Patient Global Impression of Improvement (PGI-I) were used for cure assessment scales.

Results

In total, 96 patients completed 3-year follow-up (TOT, n = 49 and mMUS, n = 47). There was no statistical difference between the procedures in terms of cure rates (87.75% and 87.23%, respectively; p = 0.614). Mean VAS scores at 8 and 24 h postoperatively were significantly higher in the TOT group (p < 0.05). There was no significant difference between the groups in VAS scores after 24 h. There was no significant difference between groups in terms of pad test results, ICIQ, or PGI scores at baseline and 36 months after surgery.

Conclusions

We showed that the mMUS procedure was as safe and effective as TOT, with less postoperative groin pain and complications.

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Author information

Authors and Affiliations

  1. Trabzon Faculty of Medicine, Department of Obstetrics and Gynecology, University of Health Sciences, Trabzon, Turkey

    Deniz Kulaksiz

  2. Fatih Sultan Mehmet Training and Research Hospital, Department of Urology, University of Health Sciences, Istanbul, Turkey

    Tuncay Toprak & Ayhan Verit

  3. Faculty of Medicine, Department of Urology, Kırklareli University, Kirklareli, Turkey

    Alkan Cubuk

  4. Faculty of Medicine, Department of Urology, University of Freiburg – Medical Centre, Freiburg, Germany

    Mehmet Yilmaz

Authors
  1. Deniz Kulaksiz
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  2. Tuncay Toprak
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  3. Alkan Cubuk
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  4. Mehmet Yilmaz
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  5. Ayhan Verit
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Contributions

DK and TT designed the study and wrote the manuscript. AV, AC, and MY reviewed the manuscript. TT, MY, and AV analyzed the data and created the tables and graphs. DK and TT collected and organized the patient data. All of the authors read and approved the final manuscript.

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Correspondence to Deniz Kulaksiz.

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Kulaksiz, D., Toprak, T., Cubuk, A. et al. A modified mid-urethral sling technique for stress urinary incontinence: Three-year results of a prospective randomized trial in comparison with original transobturator tape procedure. Int Urogynecol J 34, 1429–1436 (2023). https://doi.org/10.1007/s00192-022-05381-5

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  • DOI: https://doi.org/10.1007/s00192-022-05381-5

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