Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2016

01.02.2016 | Urogynecology

A comparison between adjustable single-incision sling and tension-free vaginal tape-obturator in treating stress urinary incontinence

verfasst von: Xing Xin, Yue Song, Zhijun Xia

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare the subjective and objective cure rates, postoperative pain, postoperative complications, and postoperative quality of life of adjustable single-incision sling (Ajust®) versus tension-free vaginal tape-obturator (TVT-O™) in the treatment of female stress urinary incontinence (SUI).

Methods

Female patients with SUI (N = 368) were randomized to receive either Ajust® (N = 184) or TVT-O™ procedure (N = 184) between January 2012 and October 2013. Efficacy was evaluated using cure rate, postoperative complications, postoperative pain profile (using Visual Analogue Scale), Patient Global Impression of Improvement Scale, and International Consultation on Incontinence Questionnaire-Short Form.

Results

The patients from Ajust® and TVT-O™ groups had no statistically significant difference in subjective and objective cure rates (94.4 vs 90.7 %, P = 0.171; 97.2 vs 90.7 %, P = 0.195). Compared with the TVT-O™ group, patients in the Ajust® group had significantly less postoperative pain, shorter operative duration, and less intraoperative blood loss (all P values < 0.05). No significant difference in perioperative complications was observed between these two groups. Patients in Ajust® group had shorter recovery time (P < 0.001) compared to TVT-O™ group. The postoperative quality of life of patients in these two groups was significantly improved compared to baseline; however, no significant difference was observed in the average improvement of life between these two groups (P = 0.115).

Conclusions

Ajust® procedure is simple, safe, and effective for the treatment of SUI. Compared with TVT-O™, patients receiving Ajust® had less intraoperative blood loss, less postoperative pain, and shorter recovery time.
Literatur
1.
Zurück zum Zitat Abrams P, Artibani W, Cardozo L, Khoury S, Wein A (2005) Clinical manual of incontinence in women, 21st edn. Health Publisher Ltd., Paris Abrams P, Artibani W, Cardozo L, Khoury S, Wein A (2005) Clinical manual of incontinence in women, 21st edn. Health Publisher Ltd., Paris
2.
Zurück zum Zitat Labrie J, Berghmans BL, Fischer K, Milani AL, van der Wijk I, Smalbraak DJ, Vollebregt A, Schellart RP, Graziosi GC, van der Ploeg JM, Brouns JF, Tiersma ES, Groenendijk AG, Scholten P, Mol BW, Blokhuis EE, Adriaanse AH, Schram A, Roovers JP, Lagro-Janssen AL, van der Vaart CH (2013) Surgery versus physiotherapy for stress urinary incontinence. New Engl J Med 369(12):1124–1133. doi:10.1056/NEJMoa1210627 PubMedCrossRef Labrie J, Berghmans BL, Fischer K, Milani AL, van der Wijk I, Smalbraak DJ, Vollebregt A, Schellart RP, Graziosi GC, van der Ploeg JM, Brouns JF, Tiersma ES, Groenendijk AG, Scholten P, Mol BW, Blokhuis EE, Adriaanse AH, Schram A, Roovers JP, Lagro-Janssen AL, van der Vaart CH (2013) Surgery versus physiotherapy for stress urinary incontinence. New Engl J Med 369(12):1124–1133. doi:10.​1056/​NEJMoa1210627 PubMedCrossRef
3.
Zurück zum Zitat Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7(2):81–85 discussion 85–86 PubMedCrossRef Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7(2):81–85 discussion 85–86 PubMedCrossRef
4.
Zurück zum Zitat Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Progres en urologie : journal de l’Association francaise d’urologie et de la Societe francaise d’urologie 11(6):1306–1313 Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Progres en urologie : journal de l’Association francaise d’urologie et de la Societe francaise d’urologie 11(6):1306–1313
5.
Zurück zum Zitat de Leval J (2003) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44(6):724–730PubMedCrossRef de Leval J (2003) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 44(6):724–730PubMedCrossRef
6.
Zurück zum Zitat Naumann G, Hagemeier T, Zachmann S, Al-Ani A, Albrich S, Skala C, Laterza R, Linaberry M, Koelbl H (2013) Long-term outcomes of the ajust adjustable single-incision sling for the treatment of stress urinary incontinence. Int Urogynecol J 24(2):231–239. doi:10.1007/s00192-012-1843-7 PubMedCrossRef Naumann G, Hagemeier T, Zachmann S, Al-Ani A, Albrich S, Skala C, Laterza R, Linaberry M, Koelbl H (2013) Long-term outcomes of the ajust adjustable single-incision sling for the treatment of stress urinary incontinence. Int Urogynecol J 24(2):231–239. doi:10.​1007/​s00192-012-1843-7 PubMedCrossRef
7.
Zurück zum Zitat Abdel-Fattah M, Agur W, Abdel-All M, Guerrero K, Allam M, Mackintosh A, Mostafa A, Yousef M (2012) Prospective multi-centre study of adjustable single-incision mini-sling (Ajust((R))) in the management of stress urinary incontinence in women: 1-year follow-up study. BJU Int 109(6):880–886. doi:10.1111/j.1464-410X.2011.10471.x PubMedCrossRef Abdel-Fattah M, Agur W, Abdel-All M, Guerrero K, Allam M, Mackintosh A, Mostafa A, Yousef M (2012) Prospective multi-centre study of adjustable single-incision mini-sling (Ajust((R))) in the management of stress urinary incontinence in women: 1-year follow-up study. BJU Int 109(6):880–886. doi:10.​1111/​j.​1464-410X.​2011.​10471.​x PubMedCrossRef
8.
Zurück zum Zitat Novara G, Artibani W, Barber MD, Chapple CR, Costantini E, Ficarra V, Hilton P, Nilsson CG, Waltregny D (2010) Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol 58(2):218–238. doi:10.1016/j.eururo.2010.04.022 PubMedCrossRef Novara G, Artibani W, Barber MD, Chapple CR, Costantini E, Ficarra V, Hilton P, Nilsson CG, Waltregny D (2010) Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol 58(2):218–238. doi:10.​1016/​j.​eururo.​2010.​04.​022 PubMedCrossRef
9.
Zurück zum Zitat Ogah J, Cody DJ, Rogerson L (2011) Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women: a short version Cochrane review. Neurourol Urodyn 30(3):284–291. doi:10.1002/nau.20980 PubMedCrossRef Ogah J, Cody DJ, Rogerson L (2011) Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women: a short version Cochrane review. Neurourol Urodyn 30(3):284–291. doi:10.​1002/​nau.​20980 PubMedCrossRef
10.
Zurück zum Zitat Mostafa A, Agur W, Abdel-All M, Guerrero K, Allam M, Lim C, Yousef M, Abdel-Fattah M (2012) A multicentre prospective randomised study of single-incision mini-sling (Ajust(®)) versus tension-free vaginal tape-obturator (TVT-O™) in the management of female stress urinary incontinence: pain profile and short-term outcomes. Eur J Obstet Gynecol Reprod Biol 165(1):115–121PubMedCrossRef Mostafa A, Agur W, Abdel-All M, Guerrero K, Allam M, Lim C, Yousef M, Abdel-Fattah M (2012) A multicentre prospective randomised study of single-incision mini-sling (Ajust(®)) versus tension-free vaginal tape-obturator (TVT-O™) in the management of female stress urinary incontinence: pain profile and short-term outcomes. Eur J Obstet Gynecol Reprod Biol 165(1):115–121PubMedCrossRef
11.
Zurück zum Zitat Meschia M, Barbacini P, Baccichet R, Buonaguidi A, Maffiolini M, Ricci L, Braghin C, Brusati V, Dell’Utri C, Spreafico L (2011) Short-term outcomes with the Ajust system: a new single incision sling for the treatment of stress urinary incontinence. Int Urogynecol J 22(2):177–182. doi:10.1007/s00192-010-1254-6 PubMedCrossRef Meschia M, Barbacini P, Baccichet R, Buonaguidi A, Maffiolini M, Ricci L, Braghin C, Brusati V, Dell’Utri C, Spreafico L (2011) Short-term outcomes with the Ajust system: a new single incision sling for the treatment of stress urinary incontinence. Int Urogynecol J 22(2):177–182. doi:10.​1007/​s00192-010-1254-6 PubMedCrossRef
12.
Zurück zum Zitat Cornu J, Ciofu C, Sebe P, Peyrat L, Haab F (2011) Cure of women stress urinary incontinence with the Ajust single-incision sling: one year results. Neurourol Urodyn 30(6):787–1195CrossRef Cornu J, Ciofu C, Sebe P, Peyrat L, Haab F (2011) Cure of women stress urinary incontinence with the Ajust single-incision sling: one year results. Neurourol Urodyn 30(6):787–1195CrossRef
13.
14.
Zurück zum Zitat Wang YJ, Li FP, Wang Q, Yang S, Cai XG, Chen YH (2011) Comparison of three mid-urethral tension-free tapes (TVT, TVT-O, and TVT-Secur) in the treatment of female stress urinary incontinence: 1-year follow-up. Int Urogynecol J 22(11):1369–1374. doi:10.1007/s00192-011-1445-9 PubMedCrossRef Wang YJ, Li FP, Wang Q, Yang S, Cai XG, Chen YH (2011) Comparison of three mid-urethral tension-free tapes (TVT, TVT-O, and TVT-Secur) in the treatment of female stress urinary incontinence: 1-year follow-up. Int Urogynecol J 22(11):1369–1374. doi:10.​1007/​s00192-011-1445-9 PubMedCrossRef
15.
Zurück zum Zitat Abdel-Fattah M, Ramsay I, Pringle S, Hardwick C, Ali H, Young D, Mostafa A (2010) Randomised prospective single-blinded study comparing ‘inside-out’ versus ‘outside-in’ transobturator tapes in the management of urodynamic stress incontinence: 1-year outcomes from the E-TOT study. BJOG: Int J Obstet Gynaecol 117(7):870–878. doi:10.1111/j.1471-0528.2010.02544.x CrossRef Abdel-Fattah M, Ramsay I, Pringle S, Hardwick C, Ali H, Young D, Mostafa A (2010) Randomised prospective single-blinded study comparing ‘inside-out’ versus ‘outside-in’ transobturator tapes in the management of urodynamic stress incontinence: 1-year outcomes from the E-TOT study. BJOG: Int J Obstet Gynaecol 117(7):870–878. doi:10.​1111/​j.​1471-0528.​2010.​02544.​x CrossRef
16.
Zurück zum Zitat Liapis A, Georgantopoulou C, Bakas P (2010) Short term results of the Ajust adjustable single incision sling procedure for the treatment of urodynamic stress urinary incontinence. Int Urogynecol J 21:S1–428CrossRef Liapis A, Georgantopoulou C, Bakas P (2010) Short term results of the Ajust adjustable single incision sling procedure for the treatment of urodynamic stress urinary incontinence. Int Urogynecol J 21:S1–428CrossRef
17.
Zurück zum Zitat Naumann G, Hagemeier T, Zachmann S (2010) AjustTM fully adjustable single incision sling for the treatment of stress urinary incontinence: 1 year follow-up on a new minimal-invasive treatment for female SUI. Int Urogynecol J 21:S1–428 Naumann G, Hagemeier T, Zachmann S (2010) AjustTM fully adjustable single incision sling for the treatment of stress urinary incontinence: 1 year follow-up on a new minimal-invasive treatment for female SUI. Int Urogynecol J 21:S1–428
19.
Zurück zum Zitat Hinoul P, Vervest HA, den Boon J, Venema PL, Lakeman MM, Milani AL, Roovers JP (2011) A randomized, controlled trial comparing an innovative single incision sling with an established transobturator sling to treat female stress urinary incontinence. J Urol 185(4):1356–1362. doi:10.1016/j.juro.2010.11.083 PubMedCrossRef Hinoul P, Vervest HA, den Boon J, Venema PL, Lakeman MM, Milani AL, Roovers JP (2011) A randomized, controlled trial comparing an innovative single incision sling with an established transobturator sling to treat female stress urinary incontinence. J Urol 185(4):1356–1362. doi:10.​1016/​j.​juro.​2010.​11.​083 PubMedCrossRef
Metadaten
Titel
A comparison between adjustable single-incision sling and tension-free vaginal tape-obturator in treating stress urinary incontinence
verfasst von
Xing Xin
Yue Song
Zhijun Xia
Publikationsdatum
01.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2016
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-015-3949-x

Weitere Artikel der Ausgabe 2/2016

Archives of Gynecology and Obstetrics 2/2016 Zur Ausgabe

Gynecologic Endocrinology and Reproductive Medicine

Association between zinc level and the risk of preeclampsia: a meta-analysis

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.