Korean J Urol.  2010 Apr;51(4):250-256.

Randomized Comparative Study of the U- and H-Type Approaches of the TVT-Secur Procedure for the Treatment of Female Stress Urinary Incontinence: One-Year Follow-Up

• Kim JJ
• Lee YS
• Lee KS

Abstract

PURPOSE
We compared outcomes of the U- and H-type approaches of the tension-free vaginal tape (TVT)-Secur procedure for the treatment of female stress urinary incontinence (SUI). MATERIALS AND METHODS: From March 2007 to July 2008, 115 women with SUI underwent TVT-Secur by a single surgeon. Patients were randomly assigned to either the U- or the H-type approach. After 12 months, postoperative changes in the Sandvik questionnaire, incontinence quality of life questionnaire (I-QoL), Bristol female lower urinary tract symptoms-scored form (BFLUTS-SF), and postoperative patient satisfaction were evaluated. Cure was regarded as no leakage on the Sandvik questionnaire. Complications were also evaluated. RESULTS: Of 115 women, 53 were treated with the U approach, and 62 women were treated with the H approach. At 12 months, 88.7% of those treated with the U approach and 87.1% of those treated with the H approach were cured (p=0.796). The I-QoL and filling, incontinence, sexual function, and QoL sum (BFLUTS-SF) scores were improved with both approaches, and there were no significant differences in the degree of improvement between approaches. Approximately 83.7% and 82.9% of the women treated with the U and H approaches, respectively, were satisfied with the outcome (p=0.858). There were 3 cases of intra-operative vaginal wall perforation in the H-type group. Immediate postoperative retention was observed in 2 women in the U-type group and 1 woman in the H-type group. One woman in the U-type group underwent tape releasing and cutting procedures for persistent large post-void residuals. CONCLUSIONS: The U- and the H-type approaches of the TVT-Secur procedure provided comparable effectiveness for the treatment of female SUI.

Keyword

Comparative study; Stress urinary incontinence; Therapy

MeSH Terms

Female
Follow-Up Studies
Humans
Patient Satisfaction
Quality of Life
Retention (Psychology)
Suburethral Slings
Urinary Incontinence
Urinary Tract

Figure

• 

  FIG. 1 Participants' diagram.

Reference

1. Melville JL, Katon W, Delaney K, Newton K. Urinary incontinence in US women: a population-based study. Arch Intern Med. 2005; 165:537–542. PMID: 15767530.

2. Thom D. Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc. 1998; 46:473–480. PMID: 9560071.

3. Wilson L, Brown JS, Shin GP, Luc KO, Subak LL. Annual direct cost of urinary incontinence. Obstet Gynecol. 2001; 98:398–406. PMID: 11530119.

4. Hampel C, Wienhold D, Benken N, Eggersmann C, Thüroff JW. Definition of overactive bladder and epidemiology of urinary incontinence. Urology. 1997; 50(6A Suppl):4–14. PMID: 9426746.

5. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003; 61:37–49. PMID: 12559262.

6. Choo MS, Ku JH, Oh SJ, Lee KS, Paick JS, Seo JT, et al. Prevalence of urinary incontinence in Korean women: an epidemiologic survey. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18:1309–1315. PMID: 17912572.

7. Thom DH, Nygaard IE, Calhoun EA. Urologic diseases in America project: urinary incontinence in women-national trends in hospitalizations, office visits, treatment and economic impact. J Urol. 2005; 173:1295–1301. PMID: 15758785.

8. Ward M, Hutton J, McDonnell R, Bachir N, Scallan E, O'Leary M, et al. Folic acid supplements to prevent neural tube defects: trends in East of Ireland 1996-2002. Ir Med J. 2004; 97:274–276. PMID: 15568585.

9. Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE, et al. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 2007; 356:2143–2155. PMID: 17517855.

10. 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. PMID: 15572486.

11. Holmgren C, Nilsson S, Lanner L, Hellberg D. Long-term results with tension-free vaginal tape on mixed and stress urinary incontinence. Obstet Gynecol. 2005; 106:38–43. PMID: 15994615.

12. Meschia M, Pifarotti P, Gattei U, Bertozzi R. Tension-free vaginal tape: analysis of risk factors for failures. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18:419–422. PMID: 16847583.

13. Lee KS, Han DH, Choi YS, Yum SH, Song SH, Doo CK, et al. A prospective trial comparing tension-free vaginal tape and transobturator vaginal tape inside-out for the surgical treatment of female stress urinary incontinence: 1-year followup. J Urol. 2007; 177:214–218. PMID: 17162048.

14. Liapis A, Bakas P, Giner M, Creatsas G. Tension-free vaginal tape versus tension-free vaginal tape obturator in women with stress urinary incontinence. Gynecol Obstet Invest. 2006; 62:160–164. PMID: 16707901.

15. Laurikainen E, Valpas A, Kivelä A, Kalliola T, Rinne K, Takala T, et al. Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2007; 109:4–11. PMID: 17197581.

16. Boyles SH, Edwards R, Gregory W, Clark A. Complications associated with transobturator sling procedures. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18:19–22. PMID: 16568214.

17. Lee KS, Choo MS, Doo CK, Han DH, Lee YS, Kim JY, et al. The long term (5-years) objective TVT success rate does not depend on predictive factors at multivariate analysis: a multicentre retrospective study. Eur Urol. 2008; 53:176–182. PMID: 17825478.

18. Lee KS, Choo MS, Lee YS, Han JY, Kim JY, Jung BJ, et al. Prospective comparison of the 'inside-out' and 'outside-in' transobturator-tape procedures for the treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19:577–582. PMID: 17940717.

19. Gagnon L, Tu L. Observational study on the implanatation of the TVT-Secur under local anesthesia. Neurourol Urodyn. 2008; 27(Suppl):14. abstract 490.

20. Bacarat F, Iglesias R, Pessoa R, Figueiredo J, Srougi M, Bruschini H. Unfavorable immediate outcome of the TVT secure sling in twenty consecutive women with stress urinary incontinence. J Urol. 2008; 179(Suppl):535–536. abstract 1566.

21. Albrich S, Naumann G, Skala CE. TVT Secur First experience after a follow-up of 17 months. Int Continence Society. 2008; 27:43. abstract 537.

22. Neuman M. Perioperative complications and early follow-up with 100 TVT-SECUR procedures. J Minim Invasive Gynecol. 2008; 15:480–484. PMID: 18539095.

23. Moore RD, Mitchell GK, Miklos JR. Single-Center Retrospective Study of the Technique, Safety, and 12-Month Efficacy of the MiniArc Single-Incision Sling: A New Minimally Invasive Procedure for Treatment of Female SUI. Surg Technol Int. 2009; 18:175–181. PMID: 19585431.

24. Novara G, Galfano A, Boscolo-Berto R, Secco S, Cavalleri S, Ficarra V, et al. Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol. 2008; 53:288–308. PMID: 18031923.

25. Sivanesan K, Abdel-Fattah M, Ghani R. External iliac artery injury during insertion of tension-free vaginal tape: a case report and literature review. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18:1105–1108. PMID: 17221147.

26. Latthe PM, Foon R, Toozs-Hobson P. Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG. 2007; 114:522–531. PMID: 17362484.

27. Long CY, Hsu CS, Wu MP, Liu CM, Wang TN, Tsai EM. Comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. Curr Opin Obstet Gynecol. 2009; 21:342–347. PMID: 19528799.

28. Long CY, Hsu CS, Liu CM, Lo TS, Wang CL, Tsai EM. Clinical and ultrasonographic comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. J Minim Invasive Gynecol. 2008; 15:425–430. PMID: 18588852.

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. PMID: 15572487.

30. Ostergard DR. The neurological control of micturition and integral voiding reflexes. Obstet Gynecol Surv. 1979; 34:417–423. PMID: 460743.