Surgical treatment of stress urinary incontinence by suburethral transobturator tape |
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Authors: | Melki E Monnier B Richard S Hocké C |
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Affiliation: | 1. Department of Urology, Cleveland Clinic Foundation, Cleveland, OH;2. Urogynecology, Hospital Dr. Sotero del Rio, Santiago, Chile;3. Division de Obstetricia y Ginecologia, Pontificia Universidad Catolica de Chile, Región Metropolitana, Chile;2. Department of Urology, Columbia University Irving Medical Center, New York, New York;3. Department of Urology, Mount Sinai, New York, New York;4. Department of Urology, Johns Hopkins, Baltimore, Maryland;5. Division of Urology, Brown University, Providence, Rhode Island |
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Abstract: | OBJECTIVE: Assessment of the suburethral transobturator tape in the treatment of female urinary stress incontinence. PATIENTS AND METHODS: Retrospective evaluation of 39 slings. Three patients (7%) were lost to follow-up. Analysis was carried on 19 out/in procedures (mainly ObTape and Uratape slings) and 17 in/out procedures (TVT-O slings). Nine patients (25%) had a history of previous stress incontinence surgery. In 21 cases (58%) there was a concomitant surgical procedure, including genital prolapse repair (12) and total hysterectomy (6). Phone interviews were conducted with the validated questionnaires MHU and Ditrovie short form. RESULTS: The mean operative time was 17 minutes (10-30). Three vaginal wounds (8%) were immediately repaired. Two urinary retentions (5%) were managed by suprapubic catheterization for more than 10 days. With a mean follow-up of 12 months (4-23) the subjective effectiveness on stress incontinence was 89% (cure: 58%; improvement: 31%). Urge incontinence symptoms were cured in 47% of mixed incontinences. Two patients reported an important dysuria. Two sling exposures occurred. Quality of life scores were significantly improved (mean 1,7 versus 3,2, p=0,002). The level of satisfaction reached 89% (very satisfied: 50%; satisfied: 39%). DISCUSSION AND CONCLUSION: This technique is safe and effective. Our results are nevertheless inferior to those previously reported. Prospective randomised studies comparing the two surgical routes are required. |
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