Success of Handmade Transobturator Slings Prepared From Conventional Polypropylene Mesh in the Treatment of Stress Urinary Incontinence in Women (original) (raw)
Related papers
International Urogynecology Journal, 2008
This study evaluated the use of traditional polypropylene mesh, used in hernias repair, as a sling in the treatment of female stress urinary incontinence (SUI). Forty patients diagnosed with SUI underwent transobturator sling fashioned from the ordinary polypropylene mesh (vypro II®). Each lateral end of the tape is secured by a zero prolene suture. The procedure was then done outside-in, and the patients were followed up. The mean operative time was 40-60 min when the procedure was performed alone or accompanied with associated pelvic floor repair. Thirty-five patients (87.5%) were cured, and two patients (5%) significantly improved, but the procedure failed in three patients (7.5%), and the slings were removed because of vaginal erosion. Polypropylene mesh transobturator sling is an easy and cheap method for the treatment of female SUI with a high success rate.
ics.org, 2013
To review the clinical outcomes of "ideal" vs "nonideal" postprostatectomy stress urinary incontinence (PPI) patients who underwent male sling placement. METHODS The medical records of 95 consecutive patients with PPI who underwent male sling insertion (AdVance male sling, American Medical Systems, Minnetonka, MN) were reviewed. Patients were divided into "ideal" vs "nonideal" cohorts. The ideal group consisted of patients with mild to moderate incontinence (<4 pads/day or <300 g daily pad weight), ability to volitionally contract the external urinary sphincter, no history of pelvic radiation or cryotherapy, no history of previous anti-incontinence surgical procedures, the ability to generate a volitional detrusor contraction when voiding, and a postvoid residual urine volume <100 mL. Patients in the nonideal group did not satisfy all these criteria. RESULTS Significant reductions in daily pad usage and weight were noted in both cohorts. In the ideal patient group, 66 of 72 patients (92%) would undergo the procedure again. Conversely, only 7 of 23 nonideal men (30%) would undergo the procedure again. CONCLUSION Preoperative patient selection can influence favorable outcomes after the treatment of PPI with AdVance male slings. Attention to ideal vs nonideal patient characteristics should be used when counseling men considering male sling surgery. UROLOGY 83: 1186e1189, 2014.
Arab Journal of Urology, 2015
To evaluate the safety and efficacy of a procedure using surgeon-tailored polypropylene mesh (STM) through a needle-less single-incision technique for treating stress urinary incontinence (SUI), aiming to decrease the cost of treatment, which is important in developing countries. Patients and methods: In all, 43 women diagnosed using a cough stress test were treated from January 2011 to June 2013 at the Urology and Gynaecology Departments (dual-centre), Cairo University Hospitals. Previous surgery was not a contra-indication. Patients with a postvoid residual urine volume of >100 mL, a bladder capacity of <300 mL, impaired compliance or neurological lesions were excluded. The Stress and Urge incontinence Quality of life Questionnaire (SUIQQ) and urodynamic variables were compared before and after surgery. The variables were compared between the baseline and postoperative follow-up values using a paired t-test, a Wilcoxon signed-rank test or McNemar's test. Results: The mean age was 42.7 years and 20 (47%) patients had associated urgency UI (UUI), whilst 21 (49%) had intrinsic sphincter deficiency. The median (range) operative duration was 14 (5-35) min. There were no complications during
Transobturator Sling Suspension for Male Urinary Incontinence Including Post-Radical Prostatectomy
European Urology, 2007
Objective: To study the anatomical effects of placing a transobturator tape (TOT) in cadavers as well as determining the clinical outcome in men with urinary incontinence. Methods: The study was a two stage study. The first phase was a cadaver study to examine the placement of the sling. The second part involved the placement of the sling in 20 men with incontinence, which occurred post-radical prostatectomy in 15 men. All patients had pre-operative and post-operative videourodynamics, maximum flow rate (Qmax) and residual urine measurement. Urethral pressure profiles and membranous urethral length were measured in five patients pre-and postoperatively. Incontinence was assessed on the basis of pad usage. Patients' satisfaction was recorded using a non-validated patient questionnaire at 6 weeks post-operatively. Results: The cadaver study revealed that a leak point pressure of 60 cmH 2 O was achieved on tensioning of the tape. In the clinical series, the mean (range) urethral closure pressure improved from 13.2 (8-22) to 86.4 (70-100) cmH 2 O following placement of the TOT. The membranous urethral length increased from a mean (range) of 3 (0-7) to 17.2 (10-22) mm following tensioning of the tape. No significant differences in Qmax pre-and postoperatively were observed. Incontinence cure rate (no pad usage) was 40% and improved rate (1-2 pads per day) was 30%. The majority of patients (12/20) were very satisfied with the procedure. Conclusions: The TOT, a novel procedure for treatment of post-radical prostatectomy incontinence, was shown to be effective and well accepted by patients.
BJU International, 2011
• To evaluate prospectively the efficacy of the retroluminar transobturator male sling (AdVance® sling) for the functional treatment of stress urinary incontinence (SUI) after prostatectomy. • A total of 137 patients with grade II-IV SUI, resulting from radical prostatectomy, were treated with the AdVance® sling in a prospective clinical study. In all, 11 patients were lost to follow-up. A total of 17 patients (13.5%) had additional adjuvant radiotherapy before sling implantation. • Before and after sling implantation, a standardized 1-h pad test was performed and post-void residual urine, uroflowmetry, quality-of-life scores and the International Index of Erectile Function (IIEF-5) were assessed. • When calculating the cure and improvement rates, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;cure&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; was defined as no pad use or one dry prophylactic pad; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;improved&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; was defined as 1-2 pads or reduction of pads ≥ 50%. • After a median (range) follow-up of 27 (20-37) months, and a mean follow-up of 27.2 months, the success rate was 75.4% with 51.6%&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;cured&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; and 23.8%&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;improved&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. • Overall daily pad use, urine loss in the 1-h pad test and quality-of-life scores improved significantly after sling implantation. • Compared with 1-year follow-up data, no worsening over time was noticed and no additional complications were seen. • With a mid-term follow-up, the retroluminar transobturator male sling is an effective, safe and attractive treatment option for SUI after radical prostatectomy. Results are stable over time.
Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie, 2013
The aim of this study was to present the results of the 2 year outcome of I-Stop TOMS™ transobturator sling for post-prostatectomy (UIPP) minor to moderate male urinary incontinence treatment. A prospective, single center study, including 26 patients with minor to moderate IUPP and operated on using a suburethral sling (MS) TOMS™ (four arms) was performed. UIPP assessment was made preoperatively and 1 year postoperatively, using validated questionnaires (SF36 and ICIQ), number of pads daily, and the 24 hours Pad-test (LPT). Telephone follow-up evaluation was performed in 21 patients over a 2 years period following surgery. Radical prostatectomy was performed 48.4 months earlier and average patient age was 67.3 years. Preoperatively, the mean number of pads used daily was 2.3 with an average weight loss of 207.1grams at LPT. At 1 year, ICIQ and SF36 scores significantly improved. Weight loss in the LPT as well as the number of pads significantly decreased (P<0.05). At 1 year, 13 p...
Journal of Reconstructive Urology, 2018
The goal of this study is describe mid-urethral sling surgery without mesh usage to avoid mesh related complications. For this purpose our modified transobturator mid-urethral sling technique with the short-term results was evaluated. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The data of 20 patients performed modified transobturator mid-urethral sling with autologous tissue were recorded. The primary endpoints of this study were improvements in The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) scores and quality of life scores, one-hour pad test measurements, and cough stress tests rates as an objective cure, and Patients Global Impressions of Improvements (PGI-I) scale as a subjective cure. Categorical variables were compared using a paired Student's t-test. R Re es su ul lt ts s: : Twenty patients with a mean age of 50.5±3.3 years and mean body mass index of 28.9±3.9 kg/m 2 , were enrolled in the study. The mean follow-up time was 3.9±0.8 months. Mean operation time was 42.7±7.5 minutes, and complication rates were 1/20 (5%). The mean PGI-I score was 2 postoperatively which means much better than preoperatively. The positive cough test rate and one-hour pad weight gain were statistically lower postoperatively. The decreases of subscores and quality of life scores of the incontinence section were statistically significant. The total ICIQ-FLUTS score and quality of life scores were significantly reduced in the postoperative period. C Co on nc cl lu us si io on n: : To avoid mesh related complications of mid-urethral sling surgeries, our modified transobturator mid-urethral sling technique is a feasible option for patients and surgeons with its short-term effectiveness and safety profile. K Ke ey yw wo or rd ds s: : Stress urinary incontinence; autograft; midurethral sling surgery; mesh; autologous fascial sling Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada, stres üriner inkontinans tedavisinde sentetik meşlerle ilişkili komplikasyonlardan kaçınabilmek için sentetik meş kullanmadan midüretral askı cerrahisi tanımlanmak istenmiştir. Bu amaçla modifiye otolog transobturator midüretral askı cerrahisi (m-OTOT) tekniğimizin kısa dönem sonuçları sunulmuştur. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : m-OTOT uygulanan 20 hastanın preop ve postop "The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS)" skorları, 1 saatlik ped testi ölçümleri, stres testi sonuçları, yaşam kalitesi ölçeği (QoL) ve postop "Patients Global Impressions of Improvements (PGI-I)" skalasını içeren datalar toplandı. Kategorik değişkenler, eşleştirilmiş bir Student t-testi kullanılarak karşılaştırıldı. B Bu ul lg gu ul la ar r: : Yaş ortalaması 50,5±3,3, beden kitle endeksi 28,9±3,9 kg/m 2 olan 20 hastanın ortalama takip süresi 3,9±0,8 aydır. Ortalama ameliyat süresi 42,7±7,5 dakika ve komplikasyon oranı 1/20 (%5) (lokal tedavi ile iyileşen vajinal erozyon)'dir. PGI-I skoru 2 olarak belirtilmiştir ve ameliyat öncesine göre daha iyi olma durumunun karşılığıdır. Pozitif stres test oranı ve 1 saatlik ped testinde ağrılık artışı oranları postoperatif dönemde anlamlı olarak düşüktü. ICIQ-FLUTS formunda inkontinans bölüm skoru ve inkontinans bölümü yaşam kalitesi skoru postop dönemde anlamlı iyileşme göstermiştir, ayrıca toplam ICIQ-FLUTS skorU ve toplam yaşam kalitesi skoru da anlamlı olarak iyileşmiştir. S So on nu uç ç: : Stres üriner inkontinans cerrahisinde mesh ile ilişkili komplikasyonlarından kaçınmak için, modifiye transobturator orta üretral sling tekniğimiz, kısa süreli etkinliği ve güvenlik profili ile hastalar ve cerrahlar için uygun bir seçenektir.
International braz j urol
Purpose: Sling as a therapeutic option for male stress urinary incontinence (SUI) has been reviewed in the last two decades, as it is a relatively simpliest surgery compared to artificial urinary sphincter and has the ability to modulate urethral compression. This study aims to evaluate the efficacy, rate of complications, quality of life and the effects on bladder emptying of the Argus T® compressive and ajustable sling in moderate and severe male SUI treatment. Materials and Methods: Men eligible for stress urinary incontinence treatment after radical prostatectomy were recruited and prospectively evaluated, from March 2010 to November 2016. It was selected outpatient men with moderate and severe SUI, after 12 months of radical prostatectomy, who have failed conservative treatment. All patients had a complete clinical and urodynamic pre and post treatment evaluation, by means of clinical history, physical examination, urine culture, 1-hour pad test and ICIq-SF questionnaire. The UDS was performed after 12, 18 and 24 months postoperatively. Results: Thirty-seven men underwent sling surgery, 19 patients (51.4%) with moderate and 18 (48.6%) with severe SUI. The minimum follow-up time was 5 years. Overall, we had a success rate of 56.7% at 60 months follow-up. After surgery, we did not observe significant changes in the urodynamic parameters evaluated during the followup. No patient had urodynamic bladder outlet obstruction (BOO) after sling implantation. Readjustment of the Argus T® sling was performed in 16 (41%) of the patients and 51% of the patients reported some adverse event. Conclusion: We demonstrate a long-term efficacy and safety of Sling Argus T® as an alternative to moderate and severe male SUI treatment. Furthermore, in our study bulbar urethra compression does not lead to bladder outlet obstruction.
International Urogynecology Journal, 2009
Introduction and hypothesis This study aims to analyze comparatively the efficacy and safety of synthetic transobturatory and aponeurotic retropubic slings, in the treatment of stress urinary incontinence (SUI) in women. Methods Patients were separated in a randomized way. Twenty-one patients were submitted to the operatory correction by the transobturatory sling technique, whereas 20 patients were operated by the retropubic sling technique. All patients were submitted to complete physical exam and urodynamic test. The "T" test and the Mann-Whitney U test were applied to establish comparisons between the two groups. Patients were followed-up for 12 months. Results Healing rate was 90.5% (19/21) and 95% (19/20), respectively after 12 months. The transobturatory group presented lesser complications rate than the retropubic group.