Efficacy and safety of polypropylene simple mesh transobturator sling (TOT) in the treatment of female stress urinary incontinence
Keywords:
SUBURETHRAL SLINGS, URINARY INCONTINENCE OF EFFORT, URODYNAMICSAbstract
Objective: to analyse efficacy, safety and complications of transobturator sling with polypropylene simple mesh as a surgical technique in the treatment of female stress urinary incontinence.
Method: we analysed the evolution of a 100 patient cohort group who had undergone polypropylene simple mesh transobturator sling surgical treatment from October, 2002 through October, 2004.
Reusable needles and polypropylene simple mesh were used in the technique, instead of the different commercial kits available.
Evaluation of patient evolution was performed in four temporal sections, especially considering efficacy of the technique, patient satisfaction and complications arousal.
Results: there were no vascular, nervous or digestive lesions during surgery. There was one (1%) case of bladder lesion caused by the transbladder passage of a needle. One patient presented post surgery retention of urine, requiring bladder catheterization; 7% presented post-surgery immediate urinary urge; 3% of patients presented vaginal mesh extrusion; 2% suffered chronic obsturator pain upon physical effort.
With regards to efficacy, procedure failed in 10% of patients, 74% are asymptomatic, and 16 % are better. Out of all patients, 70.2% are very satisfied, 17% are moderately satisfied, 6.4% are not satisfied and 6.4% feel worse.
Conclusions: after the modifications introduced, TOT is a very safe and effective technique, with a maximum of five and a half years follow-up and an acceptable rate of complications, in the treatment of female stress urinary incontinence.
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