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Readjustment results on postoperative after transobturator tape according to tape's type

READJUSTMENT RESULTS ON POSTOPERATIVE AFTER TRANSOBTURATOR TAPE ACCORDING TO TAPE’S TYPE

 

LORENZO-GÓMEZ, M.F.; SILVA-ABUÍN, J.M.; GIL-VICENTE, A.; MARTÍN-RODRÍGUEZ, A.; PÉREZHERRERO,

F.; GARCIA-GARCIA M.A.; CAÑADA-ARRIBA, F.; DÍAZ-ALFÉREZ, F.J.; HERRERO-POLO,

M.; PALACIOS-HERNÁNDEZ, A.; HEREDERO-ZORZO, O.; URRUTIA-AVISRROR, M.

Servicio y Cátedra de Urología. University Hospital. Salamanca. Spain

 

OBJECTIVES

 

The goal of this study is to evaluate which type of slings favors the postoperative

readjustment, if necessary, after surgical correction of stress urinary incontinence (SUI) with

transobturator tape (TOT).

 

METHODS

 

117 patients with SUI were treated with TOT from April 2003 to December 2007 using four

types of tapes: 35 Monarc© (AMS); 31 Safyre© (Palex); 27 Gynecare© (Ethicon) and 24 Kim

System© (Neomedic).

The same protocol was applied in all patients: Surgery preparation, surgery procedure and

postoperative care.

The vaginal tampon was removed the following day and the patients were discharged without

cutting the part of the tape that shows up at the abdominal side. The patients were evaluated

during the next 24-48 hours before discharge. Patients with Valsalva leak were readjusted

under topical anesthesia (2.5 cc of scandicaine at 2% in the two points where the tape show

up).

Follow-up: at 48 hours after the adjustment and one month.

Descriptive statistics were used.

Abstract

RESULTS

 

Mean age of 61,16 (41-81). Table I shows the number of patients operated with each type of

tape, the patients who needed readjustment, the patients who succeed, and the patients who

finally were continent.

 

 

Table 1: Readjustment after TOT.

Type of tape.

Need for

readjustment

 

Readjustment

achieved

 

Continence

after

readjustment

Monarc©N=35

N=10

N=8

7

Safyre© N=31

N=15

N=10

8

Gynecare©N=27

N=7

N=6

5

Kim

System©N=24

N=14

N=12

11

 

 

 

Monarc© tapes became deformed during the readjustment. Tapes elongated longitudinally

and contracted laterally. Safyre© tapes needed a higher quantity of anesthesia and in three

cases the silicone column came unilaterally off the sling, so patients remained incontinent.

Gynecare© and Kim System© slings were easily adjusted and did not become deformed.

 

CONCLUSIONS

 

TOT is the first procedure chosen for the treatment of SUI. The possibility to readjust the

following days after the intervention increases success. Macroporus knotless slings seem to be

the most balanced, the ones with higher resistance without deforming allowing a correct and

efficient postoperative adjustment.


M. Lorenzo, J. Silva, A. Gil, A. Martín, F. Pérez, M. García, F. Cañada, F. Díaz, et al.

University Hospital of Salamanca

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