273: Initial Experience with the Transobturator T-Sling in Women with Stress Incontinence

Abstract

To report our initial experience with the transobturator T-sling with Centrasorb and T-sling without Centrasorb (Caldera Medical, Agoura Hills, CA) for treatment of stress urinary incontinence (SUI). T-sling with Centrasorb is composed of two different materials. The lateral aspects of the sling are made of non-absorbable polypropylene (PP) mesh with a central absorbable portion made of polydiaxanone (PDO) designed to prevent urinary retention and urethral erosion. The non-absorbable T-sling is also made of PP and has no absorbable mid-portion. Prospective studies of patients with primary SUI treated with both the transobturator T-sling with a without a central absorbable portion. Urban obstetrics and gynecologic private practice. Forty patients with primary urinary incontinence due to intrinsic sphincter deficiency, urethral hypermobility or both. All patients underwent the transobturator sling procedure: twenty patients were implanted with the T-sling with Centrasorb and twenty patients, with the T-sling without Centrasorb. Preoperative work-up included a detailed history and physical exam. Q-tip test, SUI questionnaire, and urodynamic evaluation. Patients who underwent concomitant pelvic floor defect surgery were excluded. Surgery was successfully completed in all cases. Mean operating time was eighteen minutes with minimal blood loss. There were no intraoperative or postoperative complications. All patients were discharged without a catheter in twenty-four hours. No tape erosions or urinary retention occurred with either type of T-sling. Urinary incontinence was cured in all but one patient over an eighteen-month period. Our short term results reveal no differences between the transobturator T-sling with Centrasorb and the T-sling without Centrasorb. Both types were found to be safe and effective for the treatment of SUI. The procedure with either type of sling can be performed quickly with minimal morbidity and is associated with high short-term cure rates.