Abstract
Purpose
To compare safety and efficacy of surgeon-tailored polypropylene mesh through needleless single-incision technique (STM) versus tension-free vaginal tape-obturator (TVT-O) aiming to decrease cost of treatment of stress urinary incontinence (SUI). This is important in developing countries due to limited healthcare resources.
Patients and methods
A retrospective cohort study was done at Urology and Gynecology Departments (dual-center), Cairo University, from January 2011 to August 2013. STM was inserted in 72 females, while TVT-O was inserted in 48 females. Females evaluated by cough stress test, stress and urge incontinence quality of life questionnaire (SUIQQ), Q max and abdominal leak point pressure (ALPP) were included. Different factors were compared between both groups using paired t, Wilcoxon’s signed rank, McNemar, Chi-square, Fisher’s exact, independent t or Mann–Whitney tests.
Results
Age, parity, previous surgeries, ALPP, intrinsic sphincter deficiency (ISD), associated prolapse and associated prolapse repair were comparable in both groups. No significant difference was found between both groups in postoperative complications (except groin pain), cure, SUIQQ indices improvement and Q max decline. In total, 65 (90 %) cured, 6 (8 %) improved while failure was detected in one (1 %) patient in STM group, while 42 (87 %) cured, 4 (8 %) improved and failure was detected in two (4 %) patients in TVT-O group. Presence of ISD (p = 0.565), urgency (p = 0.496), UUI (p = 0.531), previous surgeries (p = 0.345), associated urogenital prolapse (p = 0.218) or associated prolapse repair (p = 0.592) did not lead to any significant difference in outcome between both groups. Cost of mesh decreased from US$500 (TVT-O) to US$10 (STM).
Conclusion
Outcome of STM is comparable to TVT-O. Furthermore, STM is more economic.
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Abbreviations
- ALPP:
-
Abdominal leak point pressure
- CST:
-
Cough stress test
- DO:
-
Detrusor overactivity
- ISD:
-
Intrinsic sphincter deficiency
- MUI:
-
Mixed urinary incontinence
- PVRU:
-
Postvoid residual urine
- Q max :
-
Maximum flow rate
- QoL:
-
Quality of life
- STM:
-
Surgeon-tailored ordinary polypropylene mesh through needleless single-incision technique
- SUI:
-
Stress urinary incontinence
- SUIQQ:
-
Stress and urgency incontinence quality of life questionnaire
- TVT:
-
Tension-free vaginal tape
- TVT-O:
-
Tension-free vaginal tape-obturator
- US:
-
Abdominal and pelvic ultrasound
- UUI:
-
Urgency urinary incontinence
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ElSheemy, M.S., Fathy, H., Hussein, H.A. et al. Surgeon-tailored polypropylene mesh as a needleless single-incision sling versus TVT-O for the treatment of female stress urinary incontinence: a comparative study. Int Urol Nephrol 47, 937–944 (2015). https://doi.org/10.1007/s11255-015-0974-4
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DOI: https://doi.org/10.1007/s11255-015-0974-4