A control study on the clinical outcome of tension-free vaginal tape-obturator and modified tension-free vaginal tape-obturator for female stress urinary incontinence / 西安交通大学学报(医学版)

ABSTRACT:Objective To evaluate the curative effect of tension-free vaginal tape-obturator (TVT-O)and modified TVT-O in treating female stress urinary incontinence (SUI).Methods We selected 1 1 3 female patients diagnosed with SUI from January to December 2013 in our department and divided them into standard TVT-O group (group A,5 6 cases)and modified TVT-O group (group B,5 7 cases).We evaluated prospectively the safety,short-term efficacy and complications of operation in the two groups.Results The length from bilateral obturator membrane to the puncture point in the skin was greater in group A than in group B.The average intraoperative blood loss was more in group A than in group B.The median NRS score of postoperatie thigh pain in group A was higher than in group B (P0.05).Conclusion Both TVT-O and modified TVT-O techniques are effective in treating female SUI.Modified TVT-O has a short path to get through the adductor muscles and less intraoperative blood loss;therefore,it can significantly reduce the complications such as postoperative pain to enhance the quality of life after operation. 

TVT-O in the treatment of stress urinary incontinence: long-term evaluation and urodynamic study / 中华泌尿外科杂志

Objective To evaluate the long-term outcomes,complications and urodynamic parameters of using tension-free vaginal tape-obturator(TVT-O)in the treatment of patients with stress urinary incontinence.Methods Preoperative and postoperative evaluations including urodynamic data and quality of life were performed for 24 patients with stress urinary incontinence who were enrolled and treated with TVT-O between May 2007 and June 2011.Results Patients completed long-term postoperative follow-up from 12 to 60 months after surgery.Twenty-one(87.5％)patients achieved long-term subjective success and 22(91.7％)achieved objective success.Surgical satisfaction and quality of life was high.Long-term postoperative abdominal leak point pressure of 23 patient was greater than 100 cm H2O,and the remaining parameters preoperative and postoperative showed no significant differences.Voiding difficulty and external reflection voding desire were the main long-term complications.Conclusions TVT-O is with few complications and high patient satisfaction.It is a simple,safe and effective procedure for treatment of patients with stress urinary incontinence.Long follow-up period is important for the comprehensive evaluation of TVT-O.Postoperative urodynamic study has significance in complications,diagnosis and evaluation.

Tension-free Vaginal Tape Obturator Inside-outside for Treating Female Stress Urinary Incontinence / 中国医科大学学报

Objective To explore the clinical efficacy of tension-free vaginal tape obturator inside-outside(TVT-O)in the treatment of female stress urinary incontinence.Methods In this study,we enrolled the patients with stress urinary incontinence who were treated with TVT-O(n=72)or midodrine hydrochloride(n=72).The patient self-evaluation and the Results of pad test and urodynamic test 6 and 24 months after the treatment were compared.Results These 2 kinds of treatment significantly improved the symptoms in patients with stress urinary incontinence,and in patients treated with TVT-O the clinical efficacy 24 months after the treatment was better.Conclusion TVT-O is safe and effective in treating female stress urinary incontinence,and the long-term follow-up and the improvement of urodynamic indices show it is better than simple drug treatment.

The comparison of treatment outcome of Transobturator tape and Tension-free vaginal tape obturator as the treatment of stress urinary incontinence / 대한산부인과학회지

OBJECTIVE: The aim of this study was to compare the treatment outcome of Transobturator tape (TOT) and Tension-free vaginal tape obturator (TVT-O) as the treatment of stress urinary incontinence (SUI). METHODS: This prospective study included 332 women who were urodynamically diagnosed as stress urinary incontinence from April 2005 to January 2007. Patients showing pelvic organ prolapse higher than stage II by the Pelvic Organ Prolapse Quantification system or patients with detrusor overactivity were excluded from this study. The patients were alternatively selected to undergo TOT (n=192) or TVT-O (n=140) procedure and followed up at 1, 3, 6, 12 months postoperatively to compare the treatment outcome. Three hundred and six of them were available at 1 year follow up, 185 had the TOT operation, 121 the TVT-O procedure. The student t-test, chi square test were used for statistical analysis. RESULTS: There were no statistically significant differences in general characteristics between two groups. No differences were found between 2 groups in the cure rates, postoperative complication such as voiding difficulty, De novo urgency, urinary tract infection, vaginal mesh erosion except groin pain. The groin pain rate of two groups showed significant difference. (TOT; 3.78% vs TVT-O; 9.92%, P=0.030). CONCLUSIONS: This study indicates that the TOT and TVT-O procedures are safe and effective treatments for female stress urinary incontinence. However, TVT-O shows high incidence of groin pain rate and it may be related to nerve irritation by inflammation of surrounding tissue around the pudendal and obturator nerve, according to anatomical differences of the tape position in two procedures.

Therapeutic effects of tension-free vaginal tape and tension-free vaginal tape obturator in women with stress urinary incontinence:meta analysis / 中华泌尿外科杂志

Objective To assess the effectiveness of tension-free vaginal tape obturator tape(TVT-O)as treatment of SUI by means of a systematic review and meta analysis.Methods Using the search terms"TVT,TVT-O,SUI,RCT,TOT",the literature in Chinese and English from January 2001 tO March 2007 on the difference of TVT and TVT-O was searched from MEDLINE,PUBMED,EMBASE,Google Scholar,CNKI,WAN FANG DATA,and criteria randomized controlled trials(RCTs)were studied by Meta-analysis in RevMan 4.2.At the same time,Ors of randomized model and fixed model were calculated tO evaluate the sensitivity.Results There were six RCTs that compared TVT-O with TVT.When compared by Subjective cure,TVT-O at 1-17 months were no better than TVT(OR 0.67;95% CI 0.40,1.13).Adverse events such as bladder injuries (OR 0.15;95% CI 0.03,0.66)was less common,where as groin/thigh pain(OR 8.61;95% CI3.03,24.52)was more common;but there were rio significant difference in de novo urgency(OR=1.16;95% CI 0.54,2.47),urinary retention(OR=0.54;95% CI 0.24,1.20)or urinary tract infection(OR=1.07;95% CI 0.61,1.87)between the tWO groups.Conclusions There is no significant difference between TVT and TVT-O.TVT-O group had no bladder injuries complications,but groin/thigh pain was more common.