Efficacy of surgical treatment of stress urinary incontinence with mini-invasive single incision sling


Authors: J. Texl;  M. Huser;  I. Belkov;  M. Juráková;  R. Hudeček;  P. Janků;  I. Rejdová;  P. Ventruba
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a FN, Brno přednosta prof. MUDr. P. Ventruba, DrSc., MBA
Published in: Ceska Gynekol 2015; 80(5): 345-350

Overview

Objective:
The purpose of this study is to evaluate the surgical treatment of stress urinary incontinence by the single incision sling Ophira (Promedon).

Design:
Prospective observational study.

Setting:
Department of Obstetrics and Gynaecology, Masaryk University and University Hospital Brno, Brno.

Methods:
Patients with confirmed urodynamic stress urinary incontinence (SUI) were included in the study. Patients with urgent urinary incontinence or mixed incontinence with predominance of urgent folder, patients with insufficiency of internal sphincter of the urethra and pelvic organ prolapse, as well as after previous surgical treatment, patients with pelvic organ prolapse or with other serious pathology of organs of small pelvis were excluded. All patients included in the study received single incision sling (SIS) Ophira (Promedon). The length of the surgery and blood loss and complication was observed. Postoperative observation one year after the treatment was set and evaluated objective and subjective parameters of SUI.

Results:
In the study were 138 patients examined, total of 45 (34.8%) were included. Postoperative observation completed 44 (97.7%) patients. Mean age was 62.3 years. The mean follow-up was 12.9 months, when 40 patients (90.9%) had a negative cough standardized test (CST). Total of 41 patients (93.1%) evaluated the operation as a major improvement by using a questionnaire Patient Global Impression of Improvement (PGI-I). Quality of life scores were evaluated by International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF). Before the surgery ranged from 14.8 ± 2.5 points, after the surgery 3.3 ± 2.0 which is an improvement of 11.5 ± 3.1 points. There weren't serious perioperative and postoperative complications.

Conclusion:
Our results are comparable with literary data and are correlated with other studies evaluating the effectiveness of other types of SIS. The method seems to be safe and efficient enough. Observing the group of patients will be continued in order to assess the short- and long-term results.

Keywords:
stress urinary incontinence, mid-urethral sling, single incision sling, efficacy, complications


Sources

1. Abdel-Fattah, M., Agur, W., Abdel-All, M., et al. Prospective multi-centre study of adjustable single-incision mini-sling (Ajust®) in the management of stress urinary incontinence in women: 1-year follow-up study. BJU Int, 2012, 109(6), p. 880–886.

2. Belkov, AI., Huser, M. Inkontinence moči u žen – možnosti její korekce. Int Med Praxi, 2009, 11(7–8), s. 351.

3. Bianchi-Ferraro, AM., Jarmy-Di Bella, Z., Castro, R., et al. Single-incision sling compared with transobturator sling for treating stress urinary incontinence: a randomized controlled trial. Int Urogynecol J, 2013, 24(9), p. 1459–1465.

4. Djehdian, LM., Araujo, MP., Takano, CC., et al. Transobturator sling compared with single-incision mini-sling for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol, 2014, 123(3), p. 553–561.

5. Dzvinčuk, P., Müller, O., Látalová, E. Inkontinence moči z pohledu gynekologa. Int Med Prax, 2008, 10(2), s. 90–95.

6. Falkert, A., Seelbach-Gobel, B. TVT versus TOT for surgical treatment of female stress urinary incontinence. Int J Gynecol Obstet, 2007, 96(1), p. 40–41.

7. Foote, A. Randomized prospective study comparing Monarc and Miniarc suburethral slings. J Obstet Gynaecol Res, 2015, 41(1), p. 127–131.

8. Franca Natale, SD., Dati, S., La Penna, C., et al. Single incision sling (Ajust™) for the treatment of female stress urinary incontinence: 2-year follow-up. Eur J Obstet Gynecol Reprod Biol, 2014, 182, p. 48–52.

9. Gorbachinsky, I., Badlani, G. Stresová močová inkontinence u žen: diagnostika a léčba na základě hodnocení AUA Guidelines. Urol List, 2011, 9(1), s. 38–43.

10. Hanuš, T. Epidemiologie inkontinence moči. Urol List, 2004, 2(1), s. 14–18.

11. Hanuš, T. Stresová inkontinence moči u žen a možnosti její farmakologické léčby. Urol List, 2005, 3(1), s. 56–62.

12. Huvar, I. TVT – nová epocha urogynekologické operativy, současná urogynekologická operativa II. Urol List, 2008, 6(2), s. 67–70.

13. Krofta, L., Feyereisl, J., Otčenášek, M., et al. Chirurgická léčba stresové inkontinence moči pomocí tahuprosté vaginální pásky. Čes Gynek, 2008, 73(4), s. 231–239.

14. Krofta, L., Feyereisl, J., Otčenášek, M., et al. TVT and TVT-O for surgical treatment of primary stress urinary incontinence: prospective randomized trial. Int Urogynecol J, 2010, 21(2), p. 141–148.

15. Luber, KM. The definition, prevalence, and risk factors for stress urinary incontinence. Rev Urol, 2004, 6 (S3), p. 3–9.

16. Mašata, J., Švabík, K., Zvára, K., et al. Porovnání krátkodobých výsledků TVT-O a TVT-S v operační léčbě stresové inkontinence moči. Čes Gynek, 2012, 77(4), s. 350–357.

17. Naumann, G., Hagemeier, T., Zachmann, S., et al. Long-term outcomes of the Ajust® adjustable single-incision sling for the treatment of stress urinary incontinence. Int Urogynecol J, 2013, 24, p. 231–239.

18. Nilsson, CG., Falconer, C., Rezapour, M. Seven-year follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol, 2004, 104(6), p. 1259–1262.

19. Oliveira, R., Botelho, F., Silva, P., et al. Exploratory study assessing efficacy and complications of TVT-O, TVT-Secur, and Mini-Arc: results at 12-month follow-up. Eur Urol, 2011, 59(6), p. 940–944.

20. Petros, PE., Ulmsten, U. Urethral pressure increase on effort originates from within the urethra, and continence from musculovaginal closure. Neurourol Urodyn, 1995, 14(4), p. 337–346.

21. Porena, M., Costantini, E., Frea, B., et al. Tension-free vaginal tape versus transobturator tape as surgery for stress urinary incontinence: results of a multicentre randomised trial. Eur Urol, 2007, 52(5), p. 1481–1490.

22. Sedláková, K., Huser, M., Belkov, AI., et al. Vedení porodu po inzerci volné vaginální pásky – kazuistika a literární přehled. Prakt Gynek, 2011, 15 (1), s.42–46.

23. Sochorová, N., Vránová, V. Inkontinence moči a její dopad na kvalitu života mnoha žen. Urol Praxi, 2008, 9(5), s. 263–266.

24. Tommaselli, GA., D'Afiero, A., Di Carlo, C., et al. Tension-free vaginal tape-O and -Secur for the treatment of stress urinary incontinence: a thirty-six-month follow-up single-blind, double-arm, randomized study. J Minim Invasive Gynecol, 2013, 20(2), p. 198–204.

25. Ulmsten, U., Johnson, P., Rezapour, M. A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Br J Obstet Gynaecol, 1999, 106 (4), p. 345–350.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account