open access
Use of autologous fascia in midurethral sling surgeries; comparison of transobtrator and retropubic ways
, 1, 1, 1, 1, 2, 3, 1
Affiliations- Department of Urology, Başaksehir Çam and Sakura City Hospital, İstanbul, Türkiye
- Department of Urology, Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye
- Faculty of Medicine, Department of Urology, Kırklareli University, Kirklareli, Türkiye
open access
Abstract
Objectives: To compare autologous transobturator-tape (A-TOT) and autologous transvaginal tape (A-TVT) surgeries in terms of effectivity and complications. Material and methods: Preoperative data, duration of the operation, complications and postoperative visual analogue scores were noted. Patients were assessed 12 months after surgery. An objective cure was defined as a negative CST and no need for reoperation due to SUI. Subjective cure was defined as a PGI-I score ≤ 2. Symptom severity and QoL were measured using the total score and the total QoL score of the ICIQ-FLUTS. Results: Retrospectively 44 patients (A-TOT:29, A-TVT:15) were enrolled in this study. Mean follow-18 months. Preoperative parameters were similar. The VAS score at the 8th hour postoperatively was higher in the A-TOT group and similar at the 24th h (p = 0.007 and p = 0.587, respectively). Grade 3 complications according to clavien dindo were only observed in the A-TOT group. At 12 month the objective cure rates according to CST were 96.5% and 100 the subjective cure rates according to PGI-I veew 96.5% and 100%. A positive CST finding was recorded in one patient (3.3%) in the A-TOT group. Total score and total quality of life (QoL) scores on the ICIQ-FLUTS were found to be significantly improved in both groups (p = 0.001 and p = 0.001, respectively) (Tab. 4). Similar improvements were found in both groups in the overall and quality of life subscores of the ICIQ-FLUTS filling and voiding sections (p = 0.476, p = 0.315, p = 0.520, and p = 0.448, respectively). Conclusions: The A-TOT technique has objective, subjective cure, and overall complication rates comparable to those of the A-TVT technique. The use of autologous fascia provides an opportunity to avoid mesh-related complications.
Abstract
Objectives: To compare autologous transobturator-tape (A-TOT) and autologous transvaginal tape (A-TVT) surgeries in terms of effectivity and complications. Material and methods: Preoperative data, duration of the operation, complications and postoperative visual analogue scores were noted. Patients were assessed 12 months after surgery. An objective cure was defined as a negative CST and no need for reoperation due to SUI. Subjective cure was defined as a PGI-I score ≤ 2. Symptom severity and QoL were measured using the total score and the total QoL score of the ICIQ-FLUTS. Results: Retrospectively 44 patients (A-TOT:29, A-TVT:15) were enrolled in this study. Mean follow-18 months. Preoperative parameters were similar. The VAS score at the 8th hour postoperatively was higher in the A-TOT group and similar at the 24th h (p = 0.007 and p = 0.587, respectively). Grade 3 complications according to clavien dindo were only observed in the A-TOT group. At 12 month the objective cure rates according to CST were 96.5% and 100 the subjective cure rates according to PGI-I veew 96.5% and 100%. A positive CST finding was recorded in one patient (3.3%) in the A-TOT group. Total score and total quality of life (QoL) scores on the ICIQ-FLUTS were found to be significantly improved in both groups (p = 0.001 and p = 0.001, respectively) (Tab. 4). Similar improvements were found in both groups in the overall and quality of life subscores of the ICIQ-FLUTS filling and voiding sections (p = 0.476, p = 0.315, p = 0.520, and p = 0.448, respectively). Conclusions: The A-TOT technique has objective, subjective cure, and overall complication rates comparable to those of the A-TVT technique. The use of autologous fascia provides an opportunity to avoid mesh-related complications.
Keywords
autologous tape; complication; stress urinary incontinence
About this articleTitle
Use of autologous fascia in midurethral sling surgeries; comparison of transobtrator and retropubic ways
Journal
Issue
Article type
Research paper
Pages
773-779
Published online
2023-10-26
Page views
139
Article views/downloads
126
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(10):773-779.
Keywords
autologous tape
complication
stress urinary incontinence
Authors
Harun Ozdemir
Yunus Çolakoglu
Kemal Topaloğlu
Emin Taha Keskin
Metin Savun
Ali Ayten
Alkan Çubuk
Abdulmuttalip Şimşek
References (25)- Muller-Arteaga C, Martin Ma, Padilla-Fernandez B, et al. Position of the Ibero-American Society of Neurourology and Urogynecology in relation to the use of synthetic suburethral meshes for the surgical treatment of female stress incontinence. Neurourol Urodyn. 2020; 39(1): 464–469.
- Ford AA, Rogerson L, Cody JD, et al. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2015; 7(7): CD006375.
- Gomes CM, Carvalho FL, Bellucci CH, et al. Update on complications of synthetic suburethral slings. Int Braz J Urol. 2017; 43(5): 822–834.
- Shah HN, Badlani GH. Mesh complications in female pelvic floor reconstructive surgery and their management: a systematic review. Indian J Urol. 2012; 28(2): 129–153.
- Khan AA, Rosenblum N, Brucker B, et al. Changes in management of stress urinary incontinence following the 2011 FDA Health Notification. Journal of Clinical Urology. 2017; 10(5): 440–448.
- Linder BJ, Elliott DS. Autologous transobturator urethral sling placement for female stress urinary incontinence: short-term outcomes. Urology. 2016; 93: 55–59.
- Çubuk A, Erbin A, Savun M, et al. Autologous transobturator midurethral sling. Turk J Urol. 2019; 45(3): 230–232.
- Vasudeva P, Tyagi V, Kumar N, et al. "Mesh free" autologous transobturator mid urethral sling placement for predominant stress urinary incontinence: A pilot study. Neurourol Urodyn. 2021; 40(2): 659–665.
- Cubuk A, Yanaral F, Savun M, et al. Modified autologous transobturator tape surgery — evaluation of short term results. Ginekol Pol. 2020; 91(2): 51–56.
- Cubuk A, Yanaral F, Sahan A, et al. Modified autologous transobturator tape surgery — a prospective comparison with transobturator tape surgery. Urology. 2020; 146: 72–78.
- Haylen BT, de Ridder D, Freeman RM, et al. International Urogynecological Association, International Continence Society. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010; 21(1): 5–26.
- Osman NI, Hillary CJ, Mangera A, et al. The midurethral fascial "sling on a string": an alternative to midurethral synthetic tapes in the era of mesh complications. Eur Urol. 2018; 74(2): 191–196.
- Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009; 250(2): 187–196.
- Braga A, Caccia G, Sorice P, et al. Tension-free vaginal tape for treatment of pure urodynamic stress urinary incontinence: efficacy and adverse effects at 17-year follow-up. BJU Int. 2018; 122(1): 113–117.
- Leone Roberti Maggiore U, Finazzi Agrò E, Soligo M, et al. Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2017; 28(8): 1119–1130.
- Ford AA, Rogerson L, Cody JD, et al. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2015; 7(7): CD006375.
- Brubaker L, Richter HE, Norton PA, et al. Urinary Incontinence Treatment Network. 5-year continence rates, satisfaction and adverse events of burch urethropexy and fascial sling surgery for urinary incontinence. J Urol. 2012; 187(4): 1324–1330.
- Rehman H, Bezerra CA, Bruschini H, et al. Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database Syst Rev. 2017; 7(7): CD001754.
- Khan ZA, Nambiar A, Morley R, et al. Long-term follow-up of a multicentre randomised controlled trial comparing tension-free vaginal tape, xenograft and autologous fascial slings for the treatment of stress urinary incontinence in women. BJU Int. 2015; 115(6): 968–977.
- Blaivas JG, Simma-Chiang V, Gul Z, et al. Surgery for stress urinary incontinence: autologous fascial sling. Urol Clin North Am. 2019; 46(1): 41–52.
- Palos CC, Maturana AP, Ghersel FR, et al. Prospective and randomized clinical trial comparing transobturator versus retropubic sling in terms of efficacy and safety. Int Urogynecol J. 2018; 29(1): 29–35.
- Mahdy A, Ghoniem GM. Autologous rectus fascia sling for treatment of stress urinary incontinence in women: A review of the literature. Neurourol Urodyn. 2019; 38 Suppl 4: S51–S58.
- Fusco F, Abdel-Fattah M, Chapple CR, et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. 2017; 72(4): 567–591.
- Brazzelli M, Javanbakht M, Imamura M, et al. Surgical treatments for women with stress urinary incontinence: the ESTER systematic review and economic evaluation. Health Technol Assess. 2019; 23(14): 1–306.
- Kenton K, Stoddard AM, Zyczynski H, et al. 5-year longitudinal follow up after retropubic and transobturator mid urethral slings. J Urol. 2015; 193(1): 203–210.
