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Efficacy and safety of TVT-O and TVT-Secur in the treatment of female stress urinary incontinence: 1-year follow-up

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Abstract

Introduction and hypothesis

To reduce complications of transobturator tension-free vaginal tape, single-incision devices were introduced in the last years. We here report a comparison between the tension-free vaginal tape-obturator (TVT-O) and the TVT-Secur techniques in terms of efficacy and safety.

Methods

Eighty-four patients with stress urinary incontinence (SUI) were scheduled to undergo TVT-O or TVT-Secur. Duration of the procedure, subjective estimate of blood loss, intraoperative and postoperative complications, postoperative postvoidal residue (PVR), time to first voiding, and pain level were recorded. Urodynamic tests, PVR, Incontinence Questionnaire Short Form (ICIQ-SF), King’s Health Questionnaire, and a urinary diary were performed before and 12 months after procedure.

Results

No differences in terms of cure rate were observed between the two groups (81.6% vs. 83.8%). Complication rate in the TVT-Secur group was lower (8.1%) than in the TVT-O group (15.8%), but not significant.

Conclusions

Both techniques seem to be effective and safe, with a low incidence of complications in both groups.

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Abbreviations

SUI:

stress urinary incontinence

TVT:

tension-free vaginal tape

TOT:

transobturator suburethral tape

TVT-O:

tension-free vaginal tape-obturator

PVR:

postvoidal residue

ICIQ-SF:

International Consultation on Incontinence Questionnaire–Short Form

KHQ:

King’s Health Questionnaire

UISS:

urinary incontinence severity score

MID:

minimally important difference

VAS:

visual analog scale

References

  1. Hannestad YS, Rortveit G, Sandvik H, Hunskaar S; Norwegian EPINCONT study (2000) Epidemiology of incontinence in the County of Nord-Trondelag. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. J Clin Epidemiol 53:1150–1157

    Article  Google Scholar 

  2. Nilsson CG, Kuuva N, Falconer C, Rezapour M, Ulmsten U (2001) Long term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 12:S5–S8

    Article  PubMed  Google Scholar 

  3. Petros PE, Ulmsten UI (1990) An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl 153:7–31

    CAS  PubMed  Google Scholar 

  4. Karram MM, Segal JL, Vassallo BJ, Kleeman SD (2003) Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol 101:929–932

    Article  PubMed  Google Scholar 

  5. Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 11:1306–1313

    CAS  PubMed  Google Scholar 

  6. Minaglia S, Ozel B, Klutke C, Ballard C, Klutke J (2004) Bladder injury during transobturator approach for female stress urinary incontinence. Minerva Urol Nefrol 56:89–98

    Google Scholar 

  7. de Leval J (2003) Novel surgincal technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44:724–730

    Article  PubMed  Google Scholar 

  8. Lee KS, Choo MS, Lee YS, Han JY, Kim JY, Jung BJ, Han DH (2008) Prospective comparison of the “inside-out” and “outside-in” transobturator-tape procedures for the treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:577–582

    Article  PubMed  Google Scholar 

  9. Neuman M (2007) TVT and TVT-obturator: comparison of two operative procedures. Eur J Obstet Gynecol Reprod Biol 131:89–92

    Article  PubMed  Google Scholar 

  10. 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 20:681–688

    Article  PubMed  Google Scholar 

  11. Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P (2004) ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 23:322–330

    Article  PubMed  Google Scholar 

  12. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. Br Obstet Gynecol 104:1374–1379

    CAS  Google Scholar 

  13. Kelleher CJ, Pleil AM, Reese Pr, Burgess SM, BRodish PH (2004) How much is enough and who says so? The case of the King’s Health Questionnaire and overactive bladder. BJOG 111:605–612

    Article  PubMed  Google Scholar 

  14. Neuman N (2008) Perioperative complications and early follow-up with 100 TVT-Secur procedures. J Minim Invasiv Gynecol 15:480–484

    Article  Google Scholar 

  15. Cody J, Wyness L, Wallace S, Glazener C, Kilonzo M, Stearns S, McCormack K, Vale L, Grant A (2003) Systemic review of the clinical effectiveness and cost-effectiveness of TVT for the treatment of urinary stress incontinence. Health Technol Assess 7:1–189

    Google Scholar 

  16. Esinler I, Zeyneloglu HB (2004) Routine cystoscopy is not needed in TOT outside-in. Eur Urol 46:675

    Article  PubMed  Google Scholar 

  17. Liapis A, Bakas P, Creastas G (2008) Long-term efficacy of tension-free vaginal tape in the management of stress urinary incontinence in women: efficacy at 5- and 7-year follow-up. Int Urogynecol J Pelvic Floor Dysfunct 19:1509–1512

    Article  CAS  PubMed  Google Scholar 

  18. Neuman M (2006) Transvaginal suture placement for bleeding control with the tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct 17:176–177

    Article  PubMed  Google Scholar 

  19. Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81:72–77

    Article  PubMed  Google Scholar 

  20. Olsson I, Kroon U (1999) A three-year post-operative evaluation of tension-free vaginal tape. Gynecol Obstet Invest 48:267–269

    Article  CAS  PubMed  Google Scholar 

  21. Neuman M (2004) Transvaginal tape readjustment after unsuccessful tension free vaginal tape operation. Neurourol Urodyn 23:282–283

    Article  PubMed  Google Scholar 

  22. Ward KL, Hilton P, UK and Ireland TVT Trial Group (2004) A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: two-year follow-up. Am J Obstet Gynecol 190:324–331

    Article  PubMed  Google Scholar 

  23. Waetjen LE, Subak LL, Shen H, Lin F, Wang TH, Vittinghoff E, Brown JS (2003) Stress urinary incontinence surgery in the United States. Obstet Gynecol 101:671–676

    Article  PubMed  Google Scholar 

  24. Martan A, Masata J, Svabik K (2007) TVT-SECUR System-tension free support of the urethra in women suffering from stress urinary incontinence-technique and initial experience. Ceska Gynekol 72:42–49

    CAS  PubMed  Google Scholar 

  25. Oliveira R, Silva A, Pinto R, Silva J, Silva C, Guimaraes M, Dinis P, Cruz F (2009) Short-term assessment of a tension-free vaginal tape for treating female stress urinary incontinence. BJU 104:225–228

    Article  Google Scholar 

  26. Meschia M, Barbacini P, Ambrogi V, Pifarotti P, Ricci L, Spreafico L (2009) TVT-Secur: a minimally invasive procedure for the treatment of primary stress urinary incontinence. One year data from a multi-centre prospective trial. Int Urogynecol J Pelvic Floor Dysfunct 20:313–317

    Article  PubMed  Google Scholar 

  27. Masata J, Martan A, Svabik K (2008) Severe bleeding from internal obturator muscle following tension-free vaginal tape Secur hammock approach procedure. Int Urogynecol J Pelvic Floor Dysfunct 19:1581–1583

    Article  PubMed  Google Scholar 

  28. Larsson PG, Teleman P, Persson J (2010) A serious bleeding complication with injury of the corona mortis with the TVT-Secur procedure. Int Urogynecol J Pelvic Floor Dysfunct 20(3):313–317

    Google Scholar 

  29. Martan A, Svabik K, Masata J, Koleska T, El-Haddad R, Pavlikova M (2009) Correlation between changes in ultrasound measurements and clinical curative effect of tension-free vaginal tape-Secur procedure. Int Urogynecol J Pelvic Floor Dysfunct 20:533–539

    Article  Google Scholar 

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Conflicts of interest

Giovanni A. Tommaselli and Carmine Nappi accepted paid travel expenses by Gynecare. The other authors state that they have no conflicts of interest regarding this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Naples “Federico II”, Via S. Pansini, 5, 80131, Naples, Italy

    Giovanni A. Tommaselli, Costantino Di Carlo, Virginia Gargano, Carmen Formisano, Mariamaddalena Scala & Carmine Nappi

Authors
  1. Giovanni A. Tommaselli
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  2. Costantino Di Carlo
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  3. Virginia Gargano
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  4. Carmen Formisano
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  5. Mariamaddalena Scala
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  6. Carmine Nappi
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Corresponding author

Correspondence to Giovanni A. Tommaselli.

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Tommaselli, G.A., Di Carlo, C., Gargano, V. et al. Efficacy and safety of TVT-O and TVT-Secur in the treatment of female stress urinary incontinence: 1-year follow-up. Int Urogynecol J 21, 1211–1217 (2010). https://doi.org/10.1007/s00192-010-1181-6

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  • DOI: https://doi.org/10.1007/s00192-010-1181-6

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