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International Urogynecology Journal

, Volume 26, Issue 10, pp 1533–1540 | Cite as

Surgeon-tailored polypropylene mesh as a tension-free vaginal tape-obturator versus original TVT-O for the treatment of female stress urinary incontinence: a long-term comparative study

  • Mohammed S. ElSheemyEmail author
  • Hesham Fathy
  • Hussein A. Hussein
  • Ragheb Elsergany
  • Eman A. Hussein
Original Article

Abstract

Introduction and hypothesis

The objective of the study was to compare the safety and efficacy of surgeon-tailored polypropylene mesh (STM) through tension-free vaginal tape-obturator (TVT-O) versus original TVT-O in the treatment of stress urinary incontinence (SUI) aiming to decrease the cost of treatment. This is important in developing countries due to limited health care resources.

Methods

A retrospective cohort study was done at the Urology and Gynecology Departments (dual-center), Cairo University from May 2007 to June 2010. Women evaluated by cough stress test, Stress and Urge Incontinence and Quality of Life Questionnaire (SUIQQ), maximum flow rate (Qmax), and abdominal leak point pressure (ALPP) with follow-up for at least 48 months were included. Patients with post-void residual urine > 100 ml, bladder capacity < 300 ml, or impaired compliance were excluded. The effect of different factors on outcome was compared between both groups pre- and postoperatively using the paired t, Wilcoxon signed rank, McNemar, chi-square, Fisher’s exact, independent t, or Mann–Whitney tests.

Results

STM and TVT-O were inserted in 79 and 66 women, respectively. Intrinsic sphincter deficiency, ALPP, previous surgeries, associated urgency, urgency urinary incontinence (UUI), and prolapse were comparable in both groups. Operative duration was longer in STM by 10 min. No significant difference was found between both groups in complications (p = 0.462), cure (p = 0.654), and different indices of SUIQQ. In STM, 74 (93 %) were cured and 3 (4 %) improved, while SUI persisted in 2 (2 %) patients. In TVT-O, 59 (89 %) were cured and 4 (6 %) improved, while failure was detected in 3 (4 %) patients.

Conclusions

The 5-year outcome is comparable between STM and TVT-O. Furthermore, STM is more economical due to our resterilizable modified helical passers and the cheap polypropylene mesh.

Keywords

Female stress urinary incontinence Surgeon-tailored mesh Polypropylene mesh TVT-O, TOT Cost 

Abbreviations

ALPP

Abdominal leak point pressure

CST

Cough stress test

DO

Detrusor overactivity

ISD

Intrinsic sphincter deficiency

MUI

Mixed urinary incontinence

Pdet Qmax

Detrusor pressure at maximum flow rate

PVRU

Post-void residual urine

Qmax

Maximum flow rate

QOL

Quality of life

SUI

Stress urinary incontinence

SUIQQ

Stress and Urge Incontinence and Quality of Life Questionnaire

TOT

Transobturator vaginal tape outside-in

TVT

Tension-free vaginal tape

TVT-O

Transobturator vaginal tape inside-out

US

Abdominal and pelvic ultrasound

UUI

Urgency urinary incontinence

RCT

Randomized controlled trial

Notes

Conflicts of interest

None.

Funding source

None.

Authors’ contributions

M. ElSheemy: protocol development, data collection and analysis, manuscript writing/editing. H. Fathy: protocol development, data collection. A. Hussein: protocol development, data collection. R. ElSergany: protocol development, manuscript editing. E. Hussein: protocol development, data collection.

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Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  • Mohammed S. ElSheemy
    • 1
    Email author
  • Hesham Fathy
    • 1
  • Hussein A. Hussein
    • 1
  • Ragheb Elsergany
    • 1
  • Eman A. Hussein
    • 2
  1. 1.Urology Department, Kasr Al-Ainy HospitalCairo UniversityCairoEgypt
  2. 2.Department of Gynecology and Obstetrics, Kasr Al-Ainy HospitalCairo UniversityCairoEgypt

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