Korean J Urol.  2010 May;51(5):337-343.

One-Year Surgical Outcomes and Quality of Life after Minimally Invasive Sling Procedures for the Treatment of Female Stress Urinary Incontinence: TVT SECUR(R) vs. CureMesh(R)

• Joo YM
• Choe JH
• Seo JT

Abstract

PURPOSE
We compared the efficacy and safety of two minimally invasive sling procedures used to treat female stress urinary incontinence (SUI), tension-free vaginal tape (TVT) SECUR(R) and CureMesh(R), and assessed the 1-year surgical outcomes. MATERIALS AND METHODS: Sixty women with SUI were assigned to undergo either the TVT SECUR (n=38) or CureMesh (n=22) procedures between April 2007 and June 2008. Patients were monitored via outpatient visits at 1 month, 3 months, and 1 year after surgery. The efficacy of these procedures was evaluated by the cough test or by a urodynamic study. At these postoperative visits, the patients also completed several questionnaires, including incontinence quality of life, patient's perception of urgency severity, the scored form of the Bristol Female Lower Urinary Tract Symptoms, visual analog scale, and questions about perceived benefit, satisfaction, and willingness to undergo the same operation again. The objective cure rate was defined as no leakage during the cough test with a full bladder. The subjective cure rate was evaluated by self-assessment of goal achievement performed 1 year postoperatively. RESULTS: The two groups were similar in preoperative characteristics and urodynamic parameters. The objective cure rates were similar between TVT SECUR and CureMesh (68.4% vs. 77.3%). All respondents reported improvement after surgery. There were no intra-operative complications. CONCLUSIONS: Our results showed that the TVT SECUR and CureMesh procedures are both safe and simple to perform and have no significant differences in efficacy. Comparative studies with long-term follow-up are warranted to determine the true efficacy of these procedures.

Keyword

Minimally invasive surgical procedures; Stress urinary incontinence; Treatment outcome

MeSH Terms

Achievement
Cough
Surveys and Questionnaires
Female
Follow-Up Studies
Humans
Lower Urinary Tract Symptoms
Outpatients
Quality of Life
Self-Assessment
Suburethral Slings
Surgical Procedures, Minimally Invasive
Treatment Outcome
Urinary Bladder
Urinary Incontinence
Urodynamics

Reference

1. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010. 29:213–240.

2. Han DH, Kim ET, Lee KS. Long term follow-up results of anterior vaginal wall sling procedure for female stress urinary incontinence. Korean J Urol. 2004. 45:976–981.

3. Kim UH, Kim JM, Kim YH, Jeon YS, Kim ME, Lee NK, et al. The prevalence of overactive bladder syndrome and urinary incontinence in young and middle aged women. J Korean Continence Soc. 2003. 7:9–14.

4. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996. 7:81–85.

5. Nilsson CG, Kuuva N, Falconer C, Rezapour M, Ulmsten U. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2001. 12:Suppl 2. S5–S8.

6. Choi SK, Yun JM, Lee YS. Early clinical outcome and complications of tension free vaginal tape procedure in stress incontinent women. Korean J Urol. 2001. 42:589–593.

7. 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. 104:1259–1262.

8. Tsivian A, Mogutin B, Kessler O, Korczak D, Levin S, Sidi AA. Tension-free vaginal tape procedure for the treatment of female stress urinary incontinence: long-term results. J Urol. 2004. 172:998–1000.

9. Kim NS, Bae JH, Lee JG. Long-term follow-up of the tension-free vaginal tape (TVT) procedure for treating female stress urinary incontinence. Korean J Urol. 2006. 47:729–733.

10. Rezapour M, Ulmsten U. Tension-free vaginal tape (TVT) in women with mixed urinary incontinence--a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct. 2001. 12:Suppl 2. S15–S18.

11. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol. 2001. 11:1306–1313.

12. de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol. 2003. 44:724–730.

13. Molden SM, Lucente VR. New minimally invasive slings: TVT Secur. Curr Urol Rep. 2008. 9:358–361.

14. Stamey TA. Endoscopic suspension of the vesical neck for urinary incontinence in females. Report on 203 consecutive patients. Ann Surg. 1980. 192:465–471.

15. Petros PE, Ulmsten UI. An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol. 1993. 153:Suppl. 1–93.

16. Tartaglia E, Delicato G, Baffigo G, Signore S, Corvese F, Perla A, et al. Third-generation tension-free tape for female stress urinary incontinence. J Urol. 2009. 182:612–615.

17. Kuuva N, Nilsson CG. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand. 2002. 81:72–77.

18. Liapis A, Bakas P, Creatsas G. Burch colposuspension and tension-free vaginal tape in the management of stress urinary incontinence in women. Eur Urol. 2002. 41:469–473.

19. Ward KL, Hilton P. A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: two-year follow-up. Am J Obstet Gynecol. 2004. 190:324–331.

20. Boyles SH, Edwards R, Gregory W, Clark A. Complications associated with transobturator sling procedures. Int Urogynecol J Pelvic Floor Dysfunct. 2007. 18:19–22.

21. Neuman M. Perioperative complications and early follow-up with 100 TVT-SECUR procedures. J Minim Invasive Gynecol. 2008. 15:480–484.

22. Meschia M, Barbacini P, Ambrogi V, Pifarotti P, Ricci L, Spreafico L. TVT-secur: a minimally invasive procedure for the treatment of primary stress urinary incontinence. One year data from a multi-centre prospective trial. Int Urogynecol J Pelvic Floor Dysfunct. 2009. 20:313–317.

23. Oliveira R, Silva A, Pinto R, Silva J, Silva C, Guimarães M, et al. Short-term assessment of a tension-free vaginal tape for treating female stress urinary incontinence. BJU Int. 2009. 104:225–228.

24. Gauruder-Burmester A, Popken G. The MiniArc sling system in the treatment of female stress urinary incontinence. Int Braz J Urol. 2009. 35:334–341.

25. Jiménez Calvo J, Hualde Alfaro A, Raigoso Ortega O, Cebrian Lostal JL, Alvarez Bandres S, Jiménez Parra J, et al. Our experience with mini tapes (TVT Secur and MiniArc) in the surgery for stress urinary incontinence. Actas Urol Esp. 2008. 32:1013–1018.

26. Abouassaly R, Steinberg JR, Lemieux M, Marois C, Gilchrist LI, Bourque JL, et al. Complications of tension-free vaginal tape surgery: a multi-institutional review. BJU Int. 2004. 94:110–113.

27. Choe JH, Choo MS, Lee KS. The impact of tension-free vaginal tape on overactive bladder symptoms in women with stress urinary incontinence: significance of detrusor overactivity. J Urol. 2008. 179:214–219.

28. Duckett JR, Tamilselvi A. Effect of tension-free vaginal tape in women with a urodynamic diagnosis of idiopathic detrusor overactivity and stress incontinence. BJOG. 2006. 113:30–33.

29. Segal JL, Vassallo B, Kleeman S, Silva WA, Karram MM. Prevalence of persistent and de novo overactive bladder symptoms after the tension-free vaginal tape. Obstet Gynecol. 2004. 104:1263–1269.