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Archives of Gynecology and Obstetrics

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01-11-2013 | Review

Minimally invasive techniques for female stress urinary incontinence, how, why, when

Authors: Theocharis Tantanasis, Angelos Daniilidis, Athanasios Pantelis, Panagiotis Chatzis, Nikolaos Vrachnis

Published in: Archives of Gynecology and Obstetrics | Issue 5/2013

Abstract

Aim

The main purpose of this paper is to summarize the recent experience that has been obtained till now in the surgical treatment of urinary stress incontinence with less invasive techniques.

Materials and methods

We used current literature and papers published in MEDLINE and Cochrane library. The keywords used for this review were Stress urinary incontinence, Tension-free vaginal tape (TVT), Transobturator tape (TOT, TVT-O), and Single-incision mini-slings (SIMS).

Results

Tension-free vaginal tape and the transobturator urethral suspension are the most commonly used surgical approach for women who suffer from stress urinary incontinence, with long-term success rates ranging from 84 to 95 %. TVT is shown to be as effective as the older colposuspension, associated with less post-operative complications, shorter hospital stay and shorter recovery period. Bladder perforations that have been mentioned with the TVT inserter apparently do not result in any clinically significant morbidity. Major vascular and bowel injuries have been reported at rates of 0.07 and 0.04 %, respectively. Studies between TVT-O and TOT show equal effectiveness with slightly lower cure rates than TVT group, but TOT had a significant lower risk of bladder and vaginal perforations. There were no significant differences in objective cure rates between ‘inside-out’ and ‘outside-in’ transobturator tapes. Very recently a meta-analysis does not support routine use of SIMS in clinical practice, moreover suggested the retropubic TVT as the preferred choice for the management of stress urinary incontinence due to familiarity, its effectiveness, minimal invasiveness and low complication and morbidity rates as a primary procedure. Similar results have been announced in a randomized control trial in USA.

Conclusions

Certainly, larger randomized clinical trials with longer follow-up about the mentioned techniques are needed to accurately determine the efficacy and safety of the mentioned minimally invasive techniques.

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Title: Minimally invasive techniques for female stress urinary incontinence, how, why, when
Authors: Theocharis Tantanasis
Angelos Daniilidis
Athanasios Pantelis
Panagiotis Chatzis
Nikolaos Vrachnis
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-013-3024-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Minimally invasive techniques for female stress urinary incontinence, how, why, when

Abstract

Aim

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Aim

Materials and methods

Results

Conclusions

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