Functional outcomes and quality of life after transobturatory slings: hand - made vs. commercial slings
Int. braz. j. urol
;
44(3): 543-549, May-June 2018. tab, graf
Article
in English
| LILACS
| ID: biblio-954038
ABSTRACT
ABSTRACT Surgical correction is the most efficient treatment for stress urinary incontinence (SUI), and transobturator sling (TO) has optimal results. The high cost of commercially available sling kits makes it difficult the access in most Brazilian public health services. Hand-made polypropylene slings, on the other hand, have been previously reported. The aim of the present study was to compare the effectiveness and safety of commercial vs. hand-made polypropylene mesh slings. Data from 57 women who underwent consecutive TO sling surgery to treat SUI were pros- pectively collected between 2012 and 2014, and divided in two groups for further compa- rison. In Group-1, 31 women underwent surgery with commercial slings. In Group-2, 26 women underwent hand-made polypropylene slings. Women were compared according to epidemiological data, perioperative evaluation, quality of life, urodynamic study, cure and complication rates. Results were objectively (stress test with Valsalva maneuver, with at least 200mL vesical repletion) and subjectively evaluated by the Patient Global Impression of Improvement(PGI-I), Visual Analog Scale (VAS) and ICIQ-SF. Success was defined as PGI-I, VAS and negative stress test. Group-1 (n=31) and Group-2 (n=26) had a mean age of 60 vs. 58years (p=0.386). All de- mographic data were similar. The mean VLPP was 75.6cmH2O vs. 76.6cmH2O (p=0.88). The mean follow-up was 24.3 vs. 21.5months (p=0.96). Success rates were 74.2% vs. 80.2% (p=0.556), with ICIQ-SF variation of 12.6 vs.15.5 (p=0.139) and PGI-I of 71% vs. 80% (p=0.225). There was only one major complication (urethrovaginal fistula in Group-1). In conclusion, handmade and commercial slings have similar effectiveness and safety. The manufacture technique has important key-points stated in the present manuscript.
Full text:
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Index:
LILACS (Americas)
Main subject:
Prosthesis Design
/
Quality of Life
/
Urinary Incontinence, Stress
/
Suburethral Slings
Type of study:
Evaluation studies
/
Observational study
Limits:
Aged
/
Female
/
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2018
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital Israelita Albert Einstein/BR
/
Santa Casa de Misericórdia de São Paulo/BR
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