ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCE

Introduction. The optimal tension of suburethral tape is an important component of effectiveness and safety of the surgery. By now, there is no common standardized guidance on the tensioning of the sling. There is a limited number of publications, devoted to adjustable systems with the ability to co...

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Main Authors: D. D. Shkarupa, N. D. Kubin, O. Yu. Staroseltseva, A. O. Zaytseva, A. V. Pisarev, E. A. Shapovalova
Format: Article
Language:Russian
Published: Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education 2018-01-01
Series:Вестник урологии
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Online Access:https://www.urovest.ru/jour/article/view/179
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author D. D. Shkarupa
N. D. Kubin
O. Yu. Staroseltseva
A. O. Zaytseva
A. V. Pisarev
E. A. Shapovalova
author_facet D. D. Shkarupa
N. D. Kubin
O. Yu. Staroseltseva
A. O. Zaytseva
A. V. Pisarev
E. A. Shapovalova
author_sort D. D. Shkarupa
collection DOAJ
description Introduction. The optimal tension of suburethral tape is an important component of effectiveness and safety of the surgery. By now, there is no common standardized guidance on the tensioning of the sling. There is a limited number of publications, devoted to adjustable systems with the ability to correct tape tension in postoperative period. To evaluate the effectiveness of this method, the long-term results of postoperative adjustment of the sling are necessary.Aim. To evaluate the results of complicated stress urinary incontinence (SUI) surgical treatment using a transobturator adjustable sling Urosling (Lintex).Materials and methods. The study included 89 women with complicated SUI. All patients underwent the transobturator adjustable midurethral tape placement. The tension adjustment was performed during 3 days after surgery. Postoperative evaluation included vaginal examination, cough stress test, 1-h Pad-test, uroflowmetry, bladder ultrasound and post-void residual (PVR) urine measurement, validated questionnaires (UDI-6, UIQ-7, ICIQ-SF, PICQ-12) and visual analogue scale (VAS).Results. Mean operative time was 15.74±7.49 min. The tension adjustment was performed in 45.0% (40/89) patients the next day after surgery. On the second day tension re-adjustment was required in 14,6% (13/89) patients. In 3.4% (3/89) women the tension was also tuned on the 3 day. The loosening of the sling was needed in 13.5% (12/89) patients. After adjustment, all patients were continent without any signs of bladder outlet obstruction (BOO). Mean follow-up was 14.3±2.1 months. The objective cure rate was 92.9%. There was no statistically significant difference in the urodynamic parameters. Assessment of patient satisfaction showed that 95.2% (80/84) of the patients were «very» or «very» satisfied.Conclusion. The adjustable transobturator suburethral tape Urosling allows to achieve high effectiveness of treatment in female patients with complicated SUI and to reduce the risk of postoperative BOO development.
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spelling doaj-art-4d855885370c4ce786b9251da79b44012025-08-20T03:35:52ZrusMinistry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional EducationВестник урологии2308-64242018-01-0154586810.21886/2308-6424-2017-5-4-58-68140ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCED. D. Shkarupa0N. D. Kubin1O. Yu. Staroseltseva2A. O. Zaytseva3A. V. Pisarev4E. A. Shapovalova5Saint Petersburg multiprofile center; North-Western State Medical University named after I.I. MechnikovSaint Petersburg multiprofile centerSaint Petersburg multiprofile centerSaint Petersburg multiprofile centerSaint Petersburg multiprofile centerSaint Petersburg multiprofile centerIntroduction. The optimal tension of suburethral tape is an important component of effectiveness and safety of the surgery. By now, there is no common standardized guidance on the tensioning of the sling. There is a limited number of publications, devoted to adjustable systems with the ability to correct tape tension in postoperative period. To evaluate the effectiveness of this method, the long-term results of postoperative adjustment of the sling are necessary.Aim. To evaluate the results of complicated stress urinary incontinence (SUI) surgical treatment using a transobturator adjustable sling Urosling (Lintex).Materials and methods. The study included 89 women with complicated SUI. All patients underwent the transobturator adjustable midurethral tape placement. The tension adjustment was performed during 3 days after surgery. Postoperative evaluation included vaginal examination, cough stress test, 1-h Pad-test, uroflowmetry, bladder ultrasound and post-void residual (PVR) urine measurement, validated questionnaires (UDI-6, UIQ-7, ICIQ-SF, PICQ-12) and visual analogue scale (VAS).Results. Mean operative time was 15.74±7.49 min. The tension adjustment was performed in 45.0% (40/89) patients the next day after surgery. On the second day tension re-adjustment was required in 14,6% (13/89) patients. In 3.4% (3/89) women the tension was also tuned on the 3 day. The loosening of the sling was needed in 13.5% (12/89) patients. After adjustment, all patients were continent without any signs of bladder outlet obstruction (BOO). Mean follow-up was 14.3±2.1 months. The objective cure rate was 92.9%. There was no statistically significant difference in the urodynamic parameters. Assessment of patient satisfaction showed that 95.2% (80/84) of the patients were «very» or «very» satisfied.Conclusion. The adjustable transobturator suburethral tape Urosling allows to achieve high effectiveness of treatment in female patients with complicated SUI and to reduce the risk of postoperative BOO development.https://www.urovest.ru/jour/article/view/179stress urinary incontinencemidurethral slingbladder outlet obstructionadjustable slingurinary obstructionsynthetic tapemesh implants
spellingShingle D. D. Shkarupa
N. D. Kubin
O. Yu. Staroseltseva
A. O. Zaytseva
A. V. Pisarev
E. A. Shapovalova
ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCE
Вестник урологии
stress urinary incontinence
midurethral sling
bladder outlet obstruction
adjustable sling
urinary obstruction
synthetic tape
mesh implants
title ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCE
title_full ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCE
title_fullStr ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCE
title_full_unstemmed ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCE
title_short ADJUSTABLE TRANSOBTURATOR SLING FOR TREATING PATIENTS WITH COMPLICATED STRESS URINARY INCONTINENCE
title_sort adjustable transobturator sling for treating patients with complicated stress urinary incontinence
topic stress urinary incontinence
midurethral sling
bladder outlet obstruction
adjustable sling
urinary obstruction
synthetic tape
mesh implants
url https://www.urovest.ru/jour/article/view/179
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AT aozaytseva adjustabletransobturatorslingfortreatingpatientswithcomplicatedstressurinaryincontinence
AT avpisarev adjustabletransobturatorslingfortreatingpatientswithcomplicatedstressurinaryincontinence
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