Top

International Urogynecology Journal

Published in:

01-05-2013 | Original Article

A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes

Authors: Mou-Jong Sun, Ryan Sun, Yi-Ing Li

Published in: International Urogynecology Journal | Issue 5/2013

Abstract

Introduction

In this retrospective study, a comparison is made of the clinical efficacy of two stress urinary incontinence treatment apparatuses, a single-incision sling and a transobturator sling.

Methods

Eighty-five (single-incision n = 43, transobturator n = 42) consecutive patients were included in this study. Clinical outcomes were assessed by the cough stress test (CST), the pad test, the Impact Questionnaire-Short Form (IIQ-7), the Urogenital Distress Inventory six-item questionnaire (UDI-6), the Sexual Questionnaire-SF (PIS-Q), the pain score, and the postoperative changes in urodynamic parameters. A comparison of the 1-year follow-up data is presented.

Results

Three months post-surgery, 81.8% of the single-incision sling group and 74.4% of the transobturator sling group had a negative cough test and a dry pad test. One year after surgery, significantly decreasing UDI-6, IIQ-7, and increasing PIS-Q scores were observed in both groups, while the complication rates remained similar. Postoperatively, the single-incision sling group seems to show a greater improvement in UDI-6 score, require less operation time, and experience less blood loss, less postoperative pain, and a smaller decrease in maximal urethral closure pressure (MUCP).

Conclusions

These results suggest that the single-incision sling and the transobturator sling are equally as effective and safe for the treatment of stress incontinence, as evaluated during the 1-year follow-up. The insertion of a single-incision sling seems to be less painful than that of a conventional sling. One year after surgery, the MUCP and mean flow rate of the transobturator sling group had significantly decreased compared with that of the single-incision sling group.

Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29(1):75–82PubMedCrossRef

Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81(1):72–77PubMedCrossRef

Zilbert AW, Farrell SA (2001) External iliac artery laceration during tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct 12(2):141–143PubMedCrossRef

Vierhout ME (2001) Severe hemorrhage complicating tension-free vaginal tape (TVT): a case report. Int Urogynecol J Pelvic Floor Dysfunct 12(2):139–140PubMedCrossRef

Fischer A, Fink T, Zachmann S, Eickenbusch U (2005) Comparison of retropubic and outside-in transobturator sling systems for the cure of female genuine stress urinary incontinence. Eur Urol 48:799–804PubMedCrossRef

Liapis A, Bakas P, Giner M et al (2006) Tension-free vaginal tape versus tension-free vaginal tape obturator in women with stress urinary incontinence. Gynecol Obstet Investig 62:160–164CrossRef

Kennelly MJ, Moore R, Nguyen JN, Lukban JC, Siegel S (2010) Prospective evaluation of a single incision sling for stress urinary incontinence. J Urol 184(2):604–609PubMedCrossRef

De Ridder D, Berkers J, Deprest J, Verguts J, Ost D, Hamid D, Van der Aa F (2010) Single incision mini-sling versus a transobturator sling: a comparative study on MiniArc™ and Monarc™ slings. Int Urogynecol J 21:773–778PubMedCrossRef

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

10.

Moore RD, Mitchell GK, Miklos JR (2009) Single-center retrospective study of the technique, safety, and 12-month efficacy of the MiniArc single-incision sling: a new minimally invasive procedure for treatment of female SUI. Surg Technol Int 18:175–181PubMed

11.

Uebersax JS, Wyman JF, Shumaker SA et al (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence impact questionnaire and the urogenitaldistress inventory. Neurourol Urodyn 14:131–139PubMedCrossRef

12.

Rogers RG, Coates KW, Kammerer-Doak D, Khalsa S, Qualls C (2004) A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Int Urogynecol J Pelvic Floor Dysfunct 15(3):219CrossRef

13.

Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21(1):5–26, Neurourol Urodyn 29(1):4–20PubMedCrossRef

14.

Haylen BT, Freeman RM, Swift SE, Cosson M et al (2011) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Int Urogynecol J Pelvic Floor Dysfunct 22(1):3–15CrossRef

15.

Pickens RB, Stewart AF, White WM et al (2011) Long term follow-up data on the MiniArc™ single incision sling system for the treatment of stress urinary incontinence. In: 75th annual meeting of the south eastern section of the American Association of Urology

16.

Kennelly M, Moore R, Siegel S et al (2011) Two years prospective evaluation of the MiniArc8 single incision sling for treatment of stress urinary incontinence. J Urol 185(4). [CD abstract 1335]

17.

Latthe PM, Singh P, Foon R, Toozs-Hobson P (2010) Two routes of transobturator tape procedures in stress urinary incontinence: a meta-analysis with direct and indirect comparison of randomized trials. BJU Int 106(1):68–76PubMedCrossRef

18.

Alvarez-Bandrés S, Hualde-Alfaro A, Jiménez-Calvo J, Cebrián-Lostal JL, Jiménez-Parra JD, García-García D, Montesino-Semper M (2010) Complications of female urinary incontinence surgery with mini-sling system. Actas Urol Esp 34(10):893–897PubMedCrossRef

19.

Gauruder-Burmester A, Popken G (2009) The MiniArc sling system in the treatment of female stress urinary incontinence. Int Braz J Urol 35(3):334–341PubMedCrossRef

20.

Laurikainen E, Valpas A, Kivela A, Kalliola T, Rinne K, Takala T, Nilsson CG (2007) Retropubic compared with transobturator tape placement in treatment of urinary incontinence—a randomized controlled trial. Obstet Gynecol 109:4–11PubMedCrossRef

21.

Hazewinkel MH, Hinoul P, Roovers JP (2009) Persistent groin pain following a trans-obturator sling procedure for stress urinary incontinence: a diagnostic and therapeutic challenge. Int Urogynecol J Pelvic Floor Dysfunct 20(3):363–365PubMedCrossRef

22.

Klutke JJ, Klutke CG, Bergman J et al (1999) Urodynamics changes in voiding after anti-incontinence surgery: an insight into the mechanism of cure. Urology 54(6):1003–1007PubMedCrossRef

23.

Quintero F, Gorbea V, Escobar L, Rodríguez S, Campos L, Solano R (2011) Evaluation of urodynamic parameters following the placement of tension-free tape. Actas Urol Esp 35(4):208–212PubMedCrossRef

24.

Mitsui T, Tanaka H, Moriya K et al (2007) Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence. Int J Urol 14(12):1076–1079PubMedCrossRef

25.

Harris N, Swithinbank L, Hayek SA, Yang Q, Abrams P (2011) Can maximum urethral closure pressure (MUCP) be used to predict outcome of surgical treatment of stress urinary incontinence? Neurourol Urodyn 30(8):1609–1612. doi:10.1002/nau.21111 PubMedCrossRef

26.

Kapoor DS, Housami F, White P, Swithinbank L, Drake M (2012) Maximum urethral closure pressure in women: normative data and evaluation as a diagnostic test. Int Urogynecol J doi:10.1007/s00192-012-1770-7 PubMed

27.

Martan A, Masata J, Svabík K, Drahorádová P, Pavlíková M, Hlásenská J (2005) Changes in values of urethral closure pressure and its position after TVT operation–predictive value of MUCP and VLPP for successful rate of this operation. Ceska Gynekol 70(5):370–376PubMed

28.

Hsiao SM, Sheu BC, Lin HH (2008) Sequential assessment of urodynamic findings before and after transobturator tape procedure for female urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19(5):627–632PubMedCrossRef

Title: A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes
Authors: Mou-Jong Sun
Ryan Sun
Yi-Ing Li
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 5/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-012-1942-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2013

Laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse after failed transvaginal polypropylene mesh surgery

Robotic-assisted laparoscopic sacrocolpopexy for stage III pelvic organ prolapse

What is hiding behind the pessary?

Joint hypermobility, obstetrical outcomes, and pelvic floor disorders

Repeat mid-urethral sling for recurrent female stress urinary incontinence

Periurethral aggressive angiomyxoma: a case report