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Retrospective study on tension-free vaginal tape obturator (TVT-O)

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Abstract

Introduction and hypothesis

We aim to report the 3-year outcome and complications of the tension-free vaginal tape obturator (TVT-O) in treating female stress urinary incontinence (SUI).

Methods

Retrospective analysis for complications and outcome of surgery was performed in 419 women undergoing the TVT-O from 2004 to 2006.

Results

Three patients (0.8%) with an isolated TVT-O had a blood loss of more than 200 ml. Two patients (0.5%) had bladder perforation. Out of 11 readmitted patients (2.6%), 10 were due to voiding difficulty. Six patients (1.4%) required tape loosening or division. Persistent pain occurred in 3.6% and erosion in 2.4% of patients. One hundred eighty-five patients (44.2%) came for follow-up at 3 years. The actual subjective and objective success rates were 89.7% and 99.9% at 3 years follow-up, respectively. With imputation, the 3-year subjective and objective success rates were 86.9% and 97.4%, respectively.

Conclusions

The TVT-O is effective in treating female SUI with minimal complications.

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Abbreviations

TVT-O:

Tension-free vaginal tape obturator

TVT:

Tension-free vaginal tape

TOT:

Transobturator tape

CIRB:

Central Institutional Review Board

SUI:

Stress urinary incontinence

IUGA:

International Urogynecological Association

ICS:

International Continence Society

EST:

Erect stress test

CST:

Cough stress test

UDS:

Urodynamic study

BMI:

Body mass index

HRT:

Hormone replacement therapy

CISC:

Clean intermittent self-catheterization

References

  1. Bemelmans BL, Chapple CR (2003) Are slings now the gold standard treatment for the management of female urinary stress incontinence and if so which technique? Curr Opin Urol 13:301–307

    Article  PubMed  Google Scholar 

  2. Delorme E (2001) Trans-obturator urethral suspension: a minimally invasive procedure to treat female stress urinary incontinence. Prog Urol 11:1306–1313

    PubMed  CAS  Google Scholar 

  3. de Leval J (2002) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44:724–730

    Article  Google Scholar 

  4. Waltregny D, Reul O, Mathantu B, Gaspar Y, Bonnet P, de Leval J (2006) Inside out transobturator vaginal tape for the treatment of female stress urinary incontinence: interim results of a prospective study after a 1-year minimum follow up. J Urol 175:2191–2195

    Article  PubMed  Google Scholar 

  5. Waltregny D, Gaspar Y, Reul O, Hamida W, Bonnet P, de Leval J (2008) TVT-O for the treatment of female stress urinary incontinence: results of a prospective study after a 3-year minimum follow-up. Eur Urol 53:401–410

    Article  PubMed  Google Scholar 

  6. Feng CL, Chin HY, Wang KH (2008) Transobturator vaginal tape inside out procedure for stress urinary incontinence: results of 102 patients. Int Urogynecol J Pelvic Floor Dysfunct 19:1423–1427

    Article  PubMed  Google Scholar 

  7. Su TH, Huang WC, Lee MY, Lin TY, Chang HC, Chen CP (2009) Tension-free vaginal tape-obturator procedure for treatment of severe urodynamic stress incontinence: subjective and objective outcomes during 2 years of follow-up. J Obstet Gynaecol 35(6):1077–1082

    Google Scholar 

  8. Haylen BT, Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 21:5–26

    Article  Google Scholar 

  9. Liapis A, Bakas P, Giner M, Creatsas G (2006) Tension-free vaginal tape versus tension-free vaginal tape obturator in women with stress urinary incontinence. Gynecol Obstet Invest 62:160–164

    Article  PubMed  Google Scholar 

  10. Wang W, Zhu L, Lang J (2009) Transobturator tape procedure versus tension-free vaginal tape for treatment of stress urinary incontinence. International Journal of Gynecology and Obstetrics 104:113–116

    Article  PubMed  Google Scholar 

  11. Debodiance P (2006) Trans-obturator urethral sling for the surgical correction of female stress urinary incontinence: outside-in (Monarc) versus inside-out (TVT-O). Are the two ways reassuring? Eur J Obstet Gynecol RB 133:232–238

    Article  Google Scholar 

  12. Liapis A, Bakas P, Creatsas G (2007) Monarc vs TVT-O for the treatment of primary stress incontinence: a randomized study. Int Urogynecol J 19:185–190

    Article  Google Scholar 

  13. Homma Y, Batista J, Bauer S et al (2002) Urodynamics. In: Abrams P, Cardozo L, Khoury S et al (eds) Incontinence: 2nd International Consultation on Incontinence, Plymouth, UK, p 317

  14. Massey A, Abrams P (1985) Urodynamics of the female lower urinary tract. Urol Clin North Am 12:231–246

    PubMed  CAS  Google Scholar 

  15. Scotti RJ, Myers DL (1993) A comparison of the cough stress test and single-channel cystometry with multichannel urodynamic evaluation in genuine stress incontinence. Obstet Gynecol 81:430–433

    PubMed  CAS  Google Scholar 

  16. Wall LL, Wiskind AK, Taylor PA (1994) Simple bladder filling with a cough stress test compared with subtracted cystometry for the diagnosis of urinary incontinence. Am J Obstet Gynecol 171:1472–1479

    PubMed  CAS  Google Scholar 

  17. Mouritsen L, Larsen JP (2003) Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 14:122–127

    Article  PubMed  Google Scholar 

  18. Brubaker L, Shull B (2005) EGGS for patient-centered outcomes. Int Urogynecol J Pelvic Floor Dysfunct 16:171–173

    Article  PubMed  Google Scholar 

  19. Hullfish KL, Bovbjerg VE, Christianson LM, Steers WD (2005) Achieving pelvic floor dysfunction (PFD) treatment goals in medically versus surgically managed patients. 26th Annual Scientific Meeting of the American Urogynecologic Society, Atlanta, USA

  20. Swift SE, Yoon EA (1999) Test–retest reliability of the cough stress test in the evaluation of urinary incontinence. Obstet Gynecol 94:99–102

    Article  PubMed  CAS  Google Scholar 

  21. Robert M, Murphy M, Birch C, Swaby C, Ross S (2006) Five cases of tape erosion after transobturator surgery for urinary incontinence. Obstet Gynecol 107:472–474

    Article  PubMed  Google Scholar 

  22. Abdel-Fattah M, Ramsay I, Pringle S (2006) Lower urinary tract injuries after transobturator tape insertion by different routes: a large retrospective study. BJOG 113(12):1377–1381

    Article  PubMed  CAS  Google Scholar 

  23. Rafii A, Jacob D, Deval B (2006) Obturator abscess after transobturator tape for stress urinary incontinence. Obstet Gynecol 108(3):720–723

    Article  PubMed  Google Scholar 

  24. Roth TM (2007) Management of persistent groin pain after transobturator slings. Int Urogynecol J 18:1371–1373

    Article  Google Scholar 

  25. Rajan S, Kohli N (2005) Retropubic hematoma after transobturator sling procedure. Obstet Gynecol 106:1199–1202

    Article  PubMed  Google Scholar 

  26. Haensel A, Naumann G, Hohle P, Rommens PM, Koelbl H (2007) Osteomyelitis following a transobturator sling (TVT-O). BJOG 114(12):1577–1579

    Article  PubMed  CAS  Google Scholar 

  27. Waltregny D, de Leval J (2009) Review article: the TVT-obturator surgical procedure for the treatment of female stress urinary incontinence: a clinical update. Int Urogynecol J 20:337–348

    Article  Google Scholar 

  28. Domingo S, Alama P, Ruiz N, Lazaro G, Morell M, Pellicer A (2007) Transobturator tape procedure outcome: a clinical and quality of life analysis of a 1-year follow-up. Int Urogynecol J Pelvic Floor Dysfunct 18:895–900

    Article  PubMed  CAS  Google Scholar 

  29. Lim JL, Quinlan DJ (2006) Safety of a new transobturator suburethral synthetic sling (TVT-O) procedure during the training phase. J Obstet Gynaecol Can 28(3):214–217

    PubMed  Google Scholar 

  30. Descazeaud A, Salet-Lizee D, Villet R (2007) TVT-O treatment of stress urinary incontinence: intermediate and one-year results. Gynecol Obstet Fertil 35(6):523–529

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The authors would like to thank Miss Michelle (research assistant) for her hard work in helping produce this paper; Mr. Wei Xing and Mr. Ng Mor Jack for their statistical input; Dr. Sarita Narang for data collection; and Mrs. Asmah Sani and Mrs. Valemmah Kannapathy from the hospital records department for their help in collecting patient case notes.

Conflicts of interest

None.

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Authors and Affiliations

  1. Obstetrics and Gynaecology Department, Selayang Hospital, Lebuhraya Kepong-Selayang, Batu Caves, 68100, Selangor, Malaysia

    Malathi Rajendra

  2. Urogynaecology Department, KK Women’s and Children’s Hospital, Singapore, Singapore

    How Chuan Han, Lih Charn Lee, Leng Aun Arthur Tseng & Heng Fok Wong

Authors
  1. Malathi Rajendra
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  2. How Chuan Han
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  3. Lih Charn Lee
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  4. Leng Aun Arthur Tseng
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  5. Heng Fok Wong
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Correspondence to Malathi Rajendra.

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Rajendra, M., Han, H.C., Lee, L.C. et al. Retrospective study on tension-free vaginal tape obturator (TVT-O). Int Urogynecol J 23, 327–334 (2012). https://doi.org/10.1007/s00192-011-1552-7

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  • DOI: https://doi.org/10.1007/s00192-011-1552-7

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