Mp65-11 adjustment of mesh tension could be improving the success rate of anti-incontinence surgery: the efficacy and safety of transobturator adjustable tape (toa) sling operation

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II1 Apr 2016MP65-11 ADJUSTMENT OF MESH TENSION COULD BE IMPROVING THE SUCCESS RATE OF ANTI-INCONTINENCE SURGERY: THE EFFICACY AND SAFETY OF TRANSOBTURATOR ADJUSTABLE TAPE (TOA) SLING OPERATION Myung Ki Kim Myung Ki KimMyung Ki Kim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1222AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The tension-free midurethral sling procedure has been considered a standard treatment for stress urinary incontinence. However, there is a delicate balance among incontinence, continence, and obstruction after procedure because it is difficult to determine the proper tension to apply during the procedure. The transobturator adjustable tape (TOA) sling procedure is an adjustable device, which is available postoperative tension regulation. We evaluated the efficacy and safety of TOA sling operation. METHODS Between April 2009 and November 2014, consecutive 327 patients underwent the TOA sling at our institution. We retrospectively reviewed preoperative data include history taking, physical examination, stress test, and a comprehensive urodynamic examination. The suburethral tension was set on the tape by passing a Kelly clamp between the mesh and urethra such that a clamp could be passed easily between these two structures. The uroflowmetry, postvoid residual and provocation test (stair up-down and fast walking after bladder filling with 200 ml normal saline) were done 1 day after procedure. Postoperative evaluation was performed at the 1-week, 1-month and 3-month follow-up visits. RESULTS Postoperative adjustment of the mesh tension was done for 69 patients (21.1%). 27 patients (8.3%) needed increased tension for remaining stress urinary incontinence, and 42 patients (12.8%) needed reduced tension for bladder outlet obstruction. After 3 months of follow-up, the cure rate was 94.8%. The maximal flow rate was decreased significantly (p<0.001), but the postvoid residual urine was not increased significantly. And the total score of questionnaires (IQoL) was increased significantly (p=0.024). Perioperative complication associated with tension adjustment was not occurred. CONCLUSIONS Our results of postoperative tension tightening or release rate, we suggest that adjustment of mesh tension could be improving the success rate of anti-incontinence surgery with lower obstructive voiding symptoms. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e868 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Myung Ki Kim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...