ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2012
"U-method" TVT-Secur slings: Are they obstructive?
Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe TVT-Secur, a single incision sling, was introduced in 2006. It is implanted using either the "hammock" or the "U-method" technique. With the latter, the sling is tightened to create a "pillowing effect" on the urethra until a negative stress test is obtained. Short-term results seem promising. However, no study has ever reported on the voiding pattern 12 months after its implantation. Our objective was to assess whether the "U-method" technique creates an obstructive voiding pattern on pressure-flow study (PFS) 12 months after the surgery.
methodsIn this retrospective study, we reviewed the charts of 33 women who underwent the "U-method" TVT-Secur. Patients were evaluated before and 12 months postoperatively with regard to different urodynamic studies (UDS). The incontinence status was also assessed 12 months after surgery.
resultsAt 12 months after the operation, 12.5% (4/32) of the patients reported an improvement of their stress urinary incontinence, while 78.1% (25/32) reported being cured from it. The objective cure rate was 63% (19/30). One patient had a suspected bladder outlet obstruction (BOO) based on PFS. Maximal flow rate (Q(max)) was significantly lower 12 months after surgery (26.0 mL/s [range: 19.0-36.5] vs. 21.5 mL/s [range: 16.0-32.3]). However, median voided volume was lower on the postoperative uroflowmetry (446 mL [range: 348-605] vs. 320 mL [range: 243-502]). Furthermore, none of the patients complained of voiding symptoms after surgery.
conclusionsAlthough one patient had findings compatible with BOO, none complained of voiding symptoms. TVT-Secur may result in a lower Q(max). However, this finding may be due to a lower voiding volume on the postoperative UDS.
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