TVT ABBREVO: cadaveric study of tape position in foramen obturatum and adductor region
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Abstract
Introduction and hypothesis
The aim of the study was to describe fixation of the TVT ABBREVO and establish whether the tape penetrates through obturator muscles and membrane (obturator complex) into the adductor region and, if so, how far it penetrates.
Methods
Eight formalin-embalmed female cadavers were used to simulate TVT ABBREVO surgery (totalling 16 insertions). Following tape insertion, dissection was performed and ends of the tape were identified. In cases of penetration, the length of tape penetrating into the adductor region was measured.
Results
Of the 16 cases, the tape ended in the obturator membrane in eight, in the internal obturator muscle in one, and penetrated through the obturator membrane into the external obturator muscle in five, where it remained. In two cases, it penetrated through the obturator internus muscle, obturator membrane and obturator externus muscle into the group of thigh adductors; one penetration was by 3 mm and the second by 10 mm. No contact with the obturator nerve or its branches was noted in any case.
Conclusions
No TVT contact with the obturator nerve was noted; tape penetrated into the adductor region in two of the 16 cases.
Keywords
Anatomy Cadaver study Complications Sling fixation TVT ABBREVO UrogynecologyNotes
Compliance with ethical standards
Funding
This work was supported by Charles University in Prague - UNCE 204024 and by the Grant Agency of the Ministry of Health of the Czech Republic - grant NT 14162-3/2013.
Conflicts of interest
Alois Martan is a consultant for Gynecare, Bard, AMS and Astellas. Kamil Svabik received a speaker honorarium from Astellas.
References
- 1.Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81:72–77CrossRefPubMedGoogle Scholar
- 2.Ford AA, Rogerson L, Cody JD, Ogah J (2015) Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev 7:CD006375PubMedGoogle Scholar
- 3.Zhang P, Fan B, Zhang P, Han H, Xu Y, Wang B et al (2015) Meta-analysis of female stress urinary incontinence treatments with adjustable single-incision mini-slings and transobturator tension-free vaginal tape surgeries. BMC Urol 15:64CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Cornu JN, Sebe P, Peyrat L, Ciofu C, Cussenot O, Haab F (2010) Midterm prospective evaluation of TVT-Secur reveals high failure rate. Eur Urol 58:157–161CrossRefPubMedGoogle Scholar
- 5.Tommaselli GA, Di Carlo C, Gargano V, Formisano C, Scala M, Nappi C (2010) Efficacy and safety of TVT-O and TVT-Secur in the treatment of female stress urinary incontinence: 1-year follow-up. Int Urogynecol J Pelvic Floor Dysfunct 21:1211–1217CrossRefGoogle Scholar
- 6.Masata J, Svabik K, Zvara K, Drahoradova P, El Haddad R, Hubka P et al (2012) Randomized trial of a comparison of the efficacy of TVT-O and single-incision tape TVT SECUR systems in the treatment of stress urinary incontinent women--2-year follow-up. Int Urogynecol J Pelvic Floor Dysfunct 23:1403–1412CrossRefGoogle Scholar
- 7.Martan A, Svabik K, Masata J, Koleska T, El-Haddad R, Pavlikova M (2009) Initial experience with a short, tension-free vaginal tape (the tension-free vaginal tape secur system). Eur J Obstet Gynecol Reprod Biol 143:121–125CrossRefPubMedGoogle Scholar
- 8.de Leval J, Thomas A, Waltregny D (2011) The original versus a modified inside-out transobturator procedure: 1-year results of a prospective randomized trial. Int Urogynecol J 22:145–156CrossRefPubMedGoogle Scholar
- 9.Canel V, Thubert T, Wigniolle I, Fernandez H, Deffieux X (2015) Postoperative groin pain and success rates following transobturator midurethral sling placement: TVT ABBREVO(R) system versus TVT obturator system. Int Urogynecol JGoogle Scholar
- 10.Riachi L, Provost K (2013) A new minimally invasive treatment option for stress urinary incontinence in women: TVT ABBREVO, a shorter sling with an inside-out transobturator approach. Surg Technol Int 23:176–180PubMedGoogle Scholar
- 11.Shaw JS, Jeppson PC, Rardin CR (2015) Decreasing transobturator sling groin pain without decreasing efficacy using TVT-ABBREVO. Int Urogynecol JGoogle Scholar
- 12.Waltregny D, de Leval J (2012) New surgical technique for treatment of stress urinary incontinence TVT-ABBREVO from development to clinical experience. Surg Technol Int 22:149–157PubMedGoogle Scholar
- 13.Hinoul P, Bonnet P, Krofta L, Waltregny D, de Leval J (2011) An anatomic comparison of the original versus a modified inside-out transobturator procedure. Int Urogynecol J 22:997–1004CrossRefPubMedGoogle Scholar
- 14.Hubka P, Nanka O, Martan A, Svabik K, Zvarova J, Masata J (2011) Anatomical study of position of the TVT-O to the obturator nerve influenced by the position of the legs during the procedure: based upon findings at formalin-embalmed and fresh-frozen bodies. Arch Gynecol Obstet 284:901–905CrossRefPubMedGoogle Scholar
- 15.Hubka P, Doumouchtsis SK, Berger MB, DeLancey JO (2012) Variation of distances from mid-urethra to the obturator foramen: an MRI study. Int Urogynecol J Pelvic Floor Dysfunct 23:1075–1080CrossRefGoogle Scholar
- 16.Hubka P, Masata J, Nanka O, Grim M, Martan A, Zvarova J (2009) Anatomical relationship and fixation of tension-free vaginal tape Secur. Int Urogynecol J Pelvic Floor Dysfunct 20:681–688CrossRefPubMedGoogle Scholar
- 17.Hubka P, Nanka O, Martan A, Grim M, Zvarova J, Masata J (2011) TVT-S in the U position—anatomical study. Int Urogynecol J Pelvic Floor Dysfunct 22:241–246CrossRefGoogle Scholar