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Zalewski M, Kołodyńska G, Mucha A, Andrzejewski W. A Prospective Study of the Quality of Life of Patients with Stress Incontinence before and after a Transobturator Tape (TOT) Procedure-Preliminary Report. J Clin Med 2021; 10:jcm10194571. [PMID: 34640588 PMCID: PMC8509480 DOI: 10.3390/jcm10194571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Urinary incontinence (UI) is a significant social problem. The latest figures show that it affects as many as 17–60% of the female population, and it is one of the most common chronic diseases. Incontinence substantially decreases the quality of patients’ lives. The transobturator tape (TOT) procedure is the gold standard in surgical treatment due to its high efficacy and low complication rate. Objective: The aim of this study was to assess the quality of life (QoL) of patients with stress incontinence before and after the TOT procedure. Method: The study included 57 patients diagnosed with stress incontinence on the basis of ultrasonography and history. The QoL before and after surgery was measured using the Incontinence Impact Questionnaire (IIQ-7) and the Incontinence Quality of Life (I-QOL) standardised questionnaires. Results: The IIQ-7 scores for each question were higher (indicating poorer quality of life) before surgery than after surgery. The results for almost all domains were statistically significant. The I-QOL results also showed that, in most cases, the quality of patients’ lives improved after the surgery. Statistically significant changes were observed in all three questionnaire domains of avoidance/limiting behaviour, psychosocial impact, and social embarrassment. Conclusion: Surgical treatment of stress incontinence with TOT results in resolution of bothersome symptoms in the majority of patients, leading to improved comfort in life.
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Affiliation(s)
- Maciej Zalewski
- Department of Gynaecology and Obstetrics, Faculty of Health Sciences, Medical University of Wrocław, 50-367 Wrocław, Poland;
- Independent Public Health Care Center of the Ministry of the Interior and Administration in Wroclaw, Department of Gynaecology, 50-233 Wrocław, Poland
| | - Gabriela Kołodyńska
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland;
- Faculty of Medical Sciences and Health Sciences, University of Social and Medical Sciences in Warsaw, 04-367 Warszawa, Poland
- Correspondence:
| | - Anna Mucha
- Department of Genetics, Wrocław University of Environmental and Life Sciences, 50-375 Wrocław, Poland;
| | - Waldemar Andrzejewski
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland;
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Sharma JB, Thariani K, Kumari R, Kaur T, Uppal B, Pandey K, Dalal V. Short and Long Term Follow up and Efficacy of Trans Obturator Tape for Management of Stress Urinary Incontinence. J Obstet Gynaecol India 2021; 71:285-291. [PMID: 34408348 DOI: 10.1007/s13224-020-01398-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/29/2020] [Indexed: 10/22/2022] Open
Abstract
Background Stress urinary incontinence (SUI) is involuntary leakage of urine on raised intra- abdominal pressure which adversely affects quality of life usually requiring surgical treatment. Methods This is a prospective study of efficacy, cure rates and complications of tension free transobturator tape (TOT) surgery on 85 women with SUI. Pre-operatively and 6 months post-operatively International consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) scores were calculated for all patients to know the severity of incontinence and efficacy of tape. Results Mean age, parity, body mass index and mean duration of symptoms were 45.78 years, 2.68, 26.38 kg/m2 and 3.85 years, respectively. SUI was demonstrated in all cases on cough stress test and Bonney's test. Mean operative time, blood loss, post-operative analgesic injections, post- operative stay and post- operative catheterisation were 23.28 min, 45.50 ml, 1.2 injections, 1.2 days and 1.2 days. Various complications noted were excessive bleeding (3.52%), urinary retention (7.05%), urinary urgency (8.23%), urinary tract infection (2.35%), surgical site infection (1.17%), groin pain (28.23%) and mesh exposure (3.52%). At 6 months follow-up, the complete cure rate was 83.52% , partial cure rate was 11.76% and failure rate was found to be 4.70% whereas it was 79.16%, 12.0% and 8.33% respectively at 3 years follow up. 2 patients (2.35%) required burch colposuspension and 12 patients (14.11%) required pelvic floor exercises and duloxetine therapy for their symptoms. Mean pre- operative ICIQ-SF score reduced post- operatively (17.8 ± 4.67 to 2.71 ± 1.42) (p value = 0.001). Conclusion Study demonstrates short and long-term efficacy and safety of TOT for surgical management of SUI.
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Affiliation(s)
- J B Sharma
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029 India
| | - Karishma Thariani
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029 India
| | - Rajesh Kumari
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029 India
| | - Tanudeep Kaur
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029 India
| | - Bharti Uppal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029 India
| | - Kavita Pandey
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029 India
| | - Venus Dalal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No. 3064A, III Rd Floor, Teaching block, New Delhi, 110029 India
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Chang CP, Chang WH, Lee HL, Chen SF, Horng HC, Wang PH. Is the anchor matter? A short-term follow-up of the effect of mini-invasive mid urethra sling without anchor for urinary incontinence women. Taiwan J Obstet Gynecol 2020; 58:764-768. [PMID: 31759524 DOI: 10.1016/j.tjog.2019.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Stress urinary incontinence (SUI) is a common disease in aged women, and some of them need surgical correction. Recently, the mid-urethral sling is an accepted surgical approach for SUI. However, complication may occur in this surgery, and some of them are needle-related. Therefore, the needleless system may diminish this-type complication. MATERIALS AND METHODS We conducted a retrospective study to evaluate the feasibility of women with SUI undergoing needleless sling surgery in 2017. Assessments were performed by two independent special urogynecologists before, during and post operation periods. We used a category-time-site-pain code following the International Continence Society and International Urogynecological Association (ICS/IUGA) Complication Classification Code (CCC) guidelines. RESULTS Thirty-eight women were analyzed. The characteristics of the patients were 66.3 ± 12.8 years old (mean ± standard deviation) of age, 2.8 ± 1.2 of parity, and 25.6 ± 4.2 kg/m2 of body mass index. All had history of vaginal delivery for term. The objective cure rate at 2- and 4-week follow-up was 97.4% (n = 37) and 94.7% (n = 36), respectively. The subjective cure rate at 2- and 4-week follow-up was both 89.5% (n = 34). Both objective and subjective cure rates remained constant and similar to the end of 4 weeks. There were 6 patients (15.8%) who had complications according to ICS/IUGA CCC guidelines. CONCLUSION This needleless mid-urethral sling procedure seemed to be feasible in the management of women with SUI in this small series and short-term follow-up study, suggesting that a further prospective, randomized, comparative study with other tension-free procedures and mini-sling systems can be conducted.
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Affiliation(s)
- Chia-Pei Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui-Ling Lee
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shu-Fen Chen
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Huann-Cheng Horng
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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Chang CP, Hsu FK, Lai MJ, Chang WH, Lee NR, Lee HL, Horng HC, Wang PH. Uterine-preserving pelvic organ prolapse surgery using the UPHOLD LITE vaginal support system: The outcomes of 291 patients. Medicine (Baltimore) 2019; 98:e15086. [PMID: 30946362 PMCID: PMC6456022 DOI: 10.1097/md.0000000000015086] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This article aims to evaluate the safety and outcome of women with pelvic organ prolapse (POP) treated by a minimally invasive bilateral sacrospinous hysteropexy (UPHOLD LITE Vaginal Support System, Boston Scientific) without concomittent anti-incontinence surgery.This retrospective study was conducted between 2014 and 2016. Evaluated items included surgical parameter and postoperative outcome.Three hundred thirteen women with POP were eligible and 22 were excluded because of history of either or more following situations, such as hysterectomy, mesh augmentation, previous anti-incontinence procedures, and radical pelvic surgery before. With a median follow-up of 26 months, surgery-related morbidity rate was 23.7% (69/291), including 1 with bladder injury (0.3%), 2 with hematoma (0.7%), 8 with urinary tract infection (2.8%), 48 with voiding dysfunction (16.5%) and 10 with mesh problems (3.4%). Among these morbidities, 12 patients (4.1%) needed surgical intervention, including 6 for mesh problems, 1 for bladder injury, 2 for hematoma, and 3 for anti-incontinence surgery. The difference of pelvic organ prolapse quantification (POP-Q) stage before and after surgery showed a statistical significance (anterior portion from 1.36 ± 2.60 to -2.69 ± 0.26, posterior portion from -1.29 ± 2.08 to -2.46 ± 0.62, and cervix portion from 2.03 ± 4.80 to -6.98 ± 2.26, all P < .001). At the end of August 2018, re-intervention rate for POP recurrence was 2.1% (n = 6), including abdominal sacrocolpopexy (n = 1), anterior repair (n = 1), vaginal total hysterectomy and uterine-sacral ligament suspension (n = 1), vaginal total hysterectomy and LeFort (n = 1), LeFort (n = 1), and pessary support (n = 1).Because some women developed postoperative lower urinary tract symptom, preoperative evaluation, including careful and detailed history taking, and urodynamic evaluation is suggested. After adequate counseling, uterine-preserving sacrospinal ligament suspension by UPHOLD LITE Vaginal Support System surgery could be considered in the management of women with POP, because of its high successful rate (97.9%) and low morbidity rate.
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Affiliation(s)
- Chia-Pei Chang
- Department of Obstetrics and Gynecology
- Institute of Clinical Medicine
| | - Fang-Kuo Hsu
- Department of Obstetrics and Gynecology
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112
- Department of Nursing, National Yang-Ming University, Taipei 112
| | - Man-Jung Lai
- Department of Obstetrics and Gynecology
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112
- Department of Nursing, National Yang-Ming University, Taipei 112
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112
- Department of Nursing, National Yang-Ming University, Taipei 112
| | - Na-Rong Lee
- Department of Obstetrics and Gynecology
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112
- Department of Nursing, National Yang-Ming University, Taipei 112
| | - Hui-Ling Lee
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112
| | - Huann-Cheng Horng
- Department of Obstetrics and Gynecology
- Institute of Clinical Medicine
- Department of Nursing, National Yang-Ming University, Taipei 112
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology
- Institute of Clinical Medicine
- Department of Nursing, National Yang-Ming University, Taipei 112
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Wang PH. Mid-urethral sling in the management of women with stress urinary incontinence after pelvic organ prolapse treatment. Taiwan J Obstet Gynecol 2018; 57:777-778. [DOI: 10.1016/j.tjog.2018.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2018] [Indexed: 11/30/2022] Open
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