Comparison of Transobturator Tape and Mini-Sling Tissue Fixation in Female Patients Who Had Stress Urinary Incontinence.

BACKGROUND: Urinary incontinence is a significant medico-social problem and its incidence increases up to 70% in the postmenopausal period. OBJECTIVES: We aimed to compare the efficacy and safety of transobturator adjustable tape (TOT) and mini sling in female urinary incontinence. MATERIAL AND METHODS: A total of 69 patients were included in the study. Single surgeon applied TOT (n=56 with ISD) or 13 mini sling (n=13 with ISD). Patients were considered to have ISD identified by a Valsalva leak point pressure (VLPP) measurement<60 cm H2O with a volume of 150 mL in the bladder or by a maximum urethral closure pressure (MUCP) measurement<20 cm H2O with a volume of 200 mL in the bladder. The mean follow-up period was 25 months for TOT group and 24 months for mini sling group (p=0.72). RESULTS: The cough test was negative in 48 of TOT group (86%) and 11 of mini sling group (84.6%). ICIQ-SF scores for the median value decreased from 14 (11-21) preoperatively to 3 (0-9) postoperatively (p<0.05) in the TOT group, and 15 (12-23) preoperatively to 4 (0-10) postoperatively (p<0.05) in the mini sling group. The difference in the decrease of the score between two groups was not statistically significant (p=0.42). There was not any significant complication to note. The mean hospital stay for TOT group was 2.1 days (1-5), and 1.4 days (1-3) for mini sling group (p=0.12). Operation time was was significantly lower in mini-sling group than TOT group (11.6 vs. 18.4, p<0.01). CONCLUSION: Both TOT and mini-sling procedures are successful and safe procedures in the treatment of female stress urinary incontinence with ISD.

Long-term results of permanent urethral stent Memotherm implantation in the management of recurrent bulbar urethral stenosis.

UNLABELLED: What's known on the subject? and What does the study add? Milroy reported 84% success at a mean of 4.5 years follow-up by usage of a permanently implantable "urolume" spent in 1993. Memotherm was developed later, especially for urologic use. Our study is one of the largest in this urea, with a high number of patients and a long follow-up period. OBJECTIVE: • To evaluate the effectiveness and long-term results of permanent urethral stent (Memotherm) implantation in the treatment of recurrent bulbar urethral stricture. PATIENTS AND METHODS: • In all, 47 patients with a history of previous unsuccessful treatment for bulbar urethral stricture were treated using Memotherm bulbar urethral stents between 1998 and 2002. • Long-term follow-up data was analysed and discussed. RESULTS: • At the end of the 7-year period 37 of 47 patients (78.7%) had been treated successfully. • Post-micturition dribbling incontinence lasting up to 3 months after stent placement occurred in 32 (68.1%) patients, but this was reduced to only seven patients (14.9%) by the 7-year follow-up. • There was stress incontinence of various severities in nine (19.2%) patients at the 1-year follow-up. These patients were those who had stenosed urethral segments adjacent to the external sphincter. At the long-term follow-up <10% of the patients had stress incontinence complaints. CONCLUSION: • Memotherm is a good treatment option in patients with recurrent bulbar urethral stricture of any cause.