Transobturator Vaginal Tape Inside-out Research Articles

Fabrication and in vitro investigation of hyperbranched poly-lysine-grafted warp knitted polypropylene sling for potential treatment of stress urinary incontinence.

Polypropylene (PP) sling implantation is the most commonly performed procedure for women with stress urinary incontinence (SUI). However, concerns have arisen regarding complications caused by slings, including the common issue of erosion, which can be attributed to various factors such as the body's response and bacterial contamination. To address these concerns, we have developed a rectangular mesh self-locking edge sling with a large pore size and lightweight design. Promising results have been obtained from preliminary in vivo mechanical reliability tests, including uniaxial tensile tests. In comparative in vitro fixed load tensile tests and simulated Tension-free Vaginal Tape (TVT) and Transobturator Vaginal Tape inside-out (TVT-O) technique tests using commercial slings, our sling demonstrated less transverse wrinkling. Both slings achieved an effective porosity of over 45% under the TVT technique. However, the commercial sling experienced a significant reduction in effective porosity during the TVT-O technique, whereas our sling maintained a stable effective porosity with minimal wrinkling. Furthermore, we successfully developed cationic hydration rejection-driven antibacterial-anti-fouling coatings on the surface of our sling by grafting hyperbranched poly-lysine (HBPL) mediated by polynorepinephrine. The HBPL coating imparts a positive charge and hydrophilicity to the sling, resulting in elevated bactericidal activity and reducing protein adhesion. An optimal grafting concentration of 20 mg mL-1 was selected, confirming the stability and biocompatibility of the sling coating. This coating is expected to reduce the likelihood of postoperative erosion. Overall, our research represents significant advancements in improving the safety and performance of PP slings for stress urinary incontinence, potentially leading to a reduction in complications following surgery.

Long-term outcome of the transobturator vaginal tape inside out for the treatment of urethral sphincter mechanism incompetence in female dogs.

To evaluate the long-term efficacy of the transobturator vaginal tape inside out (TVT-O) in female dogs with urethral sphincter mechanism incompetence (USMI). Retrospective study. Incontinent spayed female dogs (n = 12). TVT-O tape was inserted in 12 incontinent bitches diagnosed with USMI. Follow-up information was evaluated by a telephone questionnaire, and a continence score was attributed. One year after surgery, 7 of 12 (58%) dogs were completely continent. Two dogs were removed from the long-term analysis (1 dead and 1 lost). At a median follow-up time of 85 months (range, 28-95), 4 of 10 dogs were completely continent without medical treatment. Incontinence recurred in 6 dogs at a median time of 2 months after surgery (range 1-20). Among these 6 dogs, 4 regained continence, and 2 had sporadic episodes of incontinence with additional medical treatment. No postoperative complications were encountered. TVT-O alone was successful in maintaining long-term continence in 40% of the dogs. Additional postoperative medical treatment was effective in restoring continence in another 40% of the dogs. TVT-O provides an alternative treatment of USMI in female dogs that is safe and less invasive than standard surgical techniques.

TVT-O vs. TVT for the treatment of SUI: a non-inferiority study

This study aimed to prospectively compare, in terms of efficacy and safety, the tension-free vaginal tape (TVT) and the transobturator vaginal tape inside-out (TVT-O) procedure for stress urinary incontinence. A cough stress test was applied to the objective outcomes, while urinary incontinence-specific quality of life questionnaire was applied to the subjective outcomes. A test for non-inferiority was carried out for detecting the success rate between the two groups. The objective success rates were found to be 95.4% (62/65) in the TVT group and 96.4% (108/112) in the TVT-O group. No significant difference was found between these two groups in the success rate by non-inferiority test (P < 0.0005), with significant improvement in quality of life and no significant difference in patient satisfaction rates in the two groups (P > 0.05). In the study, the TVT-O procedure could be defined to be identical to the TVT approach in success rate by non-inferiority test.

A modified inexpensive transobturator vaginal tape inside-out procedure versus tension-free vaginal tape for the treatment of SUI: a prospective comparative study

To prospectively compare, in terms of efficacy and safety, the tension-free vaginal tape (TVT) and our modified transobturator vaginal tape inside-out (TVT-O) procedure with self-tailored monofilament macroporous polypropylene mesh for stress urinary incontinence (SUI). A total of 150 women with SUI were assigned to modified TVT-O (n = 95) and TVT (n = 55), respectively, the surgical outcomes compared 1 year later. A cough stress test was applied to the objective outcomes, while urinary incontinence specific quality of life (IQoL) questionnaire, to the subjective outcomes. The objective success rates defined as a negative stress test were found to be 95% in the TVT group and 96% in the modified TVT-O group, respectively. No significant difference was found between these two groups in the cure, improvement and failure rates (all P > 0.05), with significant improvement in quality of life (QoL) and no significant difference in patient satisfaction rates in two groups. In the TVT group were found three cases of bladder injuries. In the modified TVT-O group, operative duration, blood loss and medical cost were significantly reduced compared with those in the TVT one (P < 0.01). In the study, the modified TVT-O procedure could be defined to be quicker, more economic with fewer bladder complications than the TVT approach while both were found to be manually simple and clinically mini-invasive with similar efficacy.

Transobturator Vaginal Tape Inside Out for Treatment of Urethral Sphincter Mechanism Incompetence: Preliminary Results in 7 Female Dogs

To evaluate the clinical efficacy of the transobturator vaginal tape inside-out (TVT-O) in incontinent female dogs affected with urethral sphincter mechanism incompetence (USMI) and to determine its urodynamic and morphologic effects. Case series. Incontinent spayed female dogs (n=7). TVT-O tape was inserted in 7 incontinent female dogs diagnosed with USMI. Urethral pressure profilometry (UPP) and vaginourethrograms were performed preoperatively, and 1 and 3 months postoperatively. Clinical efficacy of the technique was evaluated and complications reported. Follow-up information was evaluated by a telephone questionnaire. All dogs were continent immediately after the procedure. Incontinence recurred 2 months after surgery in 1 dog and was treated by phenylpropanolamine administration. At mean follow-up time of 11.3 months, 6 of 7 dogs were continent. An iatrogenic urethral tear occurred intraoperatively in 1 dog. No postoperative complications were encountered. The postoperative UPPs showed significantly increased maximal urethral closure pressure and integrated pressure. Postoperative vaginourethrograms were unremarkable. The surgical procedure did not modify the location of the urinary bladder neck in dogs with a "pelvic urinary bladder" preoperatively. TVT-O was efficient in maintaining short term continence in 6 of 7 dogs affected with USMI.

Functional and anatomic assessments for transobturator vaginal tape inside‐out operation for urodynamic stress incontinence

The aim of the present study was to assess by urodynamic study and chain urethrocystography the functional and anatomic changes before and after transobturator vaginal tape inside-out (TVT-O) operation. From January 2005 to February 2006, 35 women were enrolled who had urodynamic stress incontinence, with or without intrinsic sphincter deficiency, and had undergone TVT-O with regular follow-up. Investigations, including pelvic examination, pad test, urodynamic study, chain urethrocystography and questionnaire with short forms of Urogenital Distress Inventory and Incontinence Impact Questionnaire, were performed pre- and postoperatively. The mean follow-up period was 12.8 months. The subjective and objective cure rates were 80 and 71.4%, respectively. The maximal urethral pressure was significantly decreased (from 67.0 to 58.9 cmH(2)O) after surgery and bladder neck mobility was reduced. Quality of life assessment revealed significant improvement after TVT-O. TVT-O is an effective operation for female urodynamic stress incontinence. Improved postoperative bladder neck mobility showed anatomic correction, indicating a hammock effect. The decreased maximal urethral pressure may reflect neurogenic damage during surgery; thus, minimal dissection and avoidance of unnecessary dissection to prevent periurethral damage are advised.

UP-1.191: Surgical Treatment of Female Stress Urinary Incontinence with Transobturator Vaginal Tape Inside-Out: Long Term Results (Report of 159 Cases)

UP-1.191: Surgical Treatment of Female Stress Urinary Incontinence with Transobturator Vaginal Tape Inside-Out: Long Term Results (Report of 159 Cases)

An inexpensive modified transobturator vaginal tape inside-out procedure for the surgical treatment of female stress urinary incontinence

The purpose of this study was to evaluate the safety and efficacy of a modified transobturator vaginal tape inside-out (TVT-O) procedure for stress urinary incontinence (SUI) using custom-tailored polypropylene mesh and helical needles. A 1x15-cm mesh made from the Gynemesh is positioned without tension under the mid-urethra using custom-made helical needles through the obturator. The procedure was carried out in 80 consecutive patients (mean age 65.0+/-13.2 years). The mean operative time was 15 min (range 6-22 min). All patients had a follow-up visit at 1 year after surgery. Of the 80 patients, 75 (93.68%) were cured, and 5 (6.2%) were improved; no failure occurred. No bladder or urethral injuries and no vascular or neurological complications were encountered. Our modified TVT-O procedure is a simple, safe, efficacious, and economic surgical procedure for SUI. The technique avoids damage to the urethra and bladder. The promising results are currently under evaluation.

The Quality of Life after Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence

Purpose: The change of quality of life following a tension-free vaginal tape (TVT) and transobturator vaginal tape (TVT-O) procedure was investigated in patients with stress urinary incontinence. Materials and Methods: We included 86 women with stress urinary incontinence who underwent the TVT or TVT-O procedure and followed up for at least 1 year. Preoperatively, the patients were evaluated with history taking, physical examination, urodynamics to determine abdominal leak point pressure (ALPP) and preand postoperative quality of life was evaluated by incontinence quality of life questionnaire (I-QoL). The success after operation was defined as the absence of any subjective complaint of leakage. Results: The rate of cure of TVT and TVT-O procedure were 84%, 92% and the rate of improvement of them were 16%, 8%, respectively. Preoperative patient characteristics including uroflowmetric parameters and ALPP were comparable in the two groups. The I-QoL parameters one year after surgery were statistically significant increase in I-QoL scores in each groups. There were no serious or long-term complications related to both procedures. Conclusions: These data suggest that the TVT and TVT-O procedure are effective for treating female stress incontinence and also in the aspect of improving quality. (J Korean Continence Soc 2008;12:58-63)

A Comparative Study of the Tension-free Vaginal Tape and Transobturator Vaginal Tape Inside-out for the Surgical Treatment of Female Stress Urinary Incontinence

A Comparative Study of the Tension-free Vaginal Tape and Transobturator Vaginal Tape Inside-out for the Surgical Treatment of Female Stress Urinary Incontinence

A Prospective Trial Comparing Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence: 1-Year Followup

We prospectively compared the efficacy and safety of tension-free vaginal tape and transobturator vaginal tape inside-out for female stress urinary incontinence. A total of 120 women with stress urinary incontinence were alternately assigned to the tension-free vaginal tape group (60) or the transobturator vaginal tape inside-out group (60). Preoperative evaluation included urodynamic study and a Korean version of the incontinence quality of life questionnaire. One year after operation the surgical result, patient satisfaction, incontinence quality of life questionnaire, long-term complications and uroflowmetry were evaluated in the 2 groups. Patient characteristics were comparable in the 2 groups. Mean +/- SD operative time was significantly shorter in the transobturator vaginal tape inside-out vs the tension-free vaginal tape group (11 +/- 1.4 vs 15 +/- 1.8 minutes). In the transobturator vaginal tape inside-out and the tension-free vaginal tape groups the rates of cure (86.8% and 86.8%), improvement (6.6% and 8.2%) and failure (6.6% and 5.0%, respectively) were similar. Incontinence quality of life questionnaire parameters 1 year after surgery were improved significantly in each group and there was no difference between the 2 groups (p <0.001 and >0.05, respectively). There was no long-term complication in either group. Preoperative urge incontinence resolved in 80% of the tension-free vaginal tape group and in 100% of the transobturator vaginal tape inside-out group. De novo urgency developed in 4 patients (6.6%) in the transobturator vaginal tape inside-out group. The tension-free vaginal tape and transobturator vaginal tape inside-out procedures were minimally invasive and similar in operation related morbidity. Transobturator vaginal tape inside-out appeared to be as effective and safe as tension-free vaginal tape for the surgical treatment of stress urinary incontinence in women at 1-year followup.

334: A Prospective Trial Comparing Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence: 1-Year Follow-Up

You have accessJournal of UrologyDiscussed Poster, Sunday, May 21, 2006, 1:00 - 4:00 pm1 Apr 2006334: A Prospective Trial Comparing Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence: 1-Year Follow-Up Byung Joo Jung, Seung Hee Yum, Yang Soo Choi, Seung Hun Song, Chin Kyung Doo, Myung-Soo Choo, and Kyu-Sung Lee Byung Joo JungByung Joo Jung More articles by this author , Seung Hee YumSeung Hee Yum More articles by this author , Yang Soo ChoiYang Soo Choi More articles by this author , Seung Hun SongSeung Hun Song More articles by this author , Chin Kyung DooChin Kyung Doo More articles by this author , Myung-Soo ChooMyung-Soo Choo More articles by this author , and Kyu-Sung LeeKyu-Sung Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)32590-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "334: A Prospective Trial Comparing Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence: 1-Year Follow-Up." The Journal of Urology, 175(4S), p. 109 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 4SApril 2006Page: 109 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Byung Joo Jung More articles by this author Seung Hee Yum More articles by this author Yang Soo Choi More articles by this author Seung Hun Song More articles by this author Chin Kyung Doo More articles by this author Myung-Soo Choo More articles by this author Kyu-Sung Lee More articles by this author Expand All Advertisement Loading ...

Early Experience with Transobturator Vaginal Tape Inside-out(TVT-O) Procedure for the Treatment of Female Stress Urinary Incontinence

Early Experience with Transobturator Vaginal Tape Inside-out(TVT-O) Procedure for the Treatment of Female Stress Urinary Incontinence

A Prospective Trial Comparing Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence: One-Year Follow up

A Prospective Trial Comparing Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence: One-Year Follow up

V935: Novel Surgical Technique for the Treatment of Female Stress Urinary Incontinence: Transobturator Vaginal Tape Inside-Out

You have accessJournal of UrologyVideo Session, Monday, May 10, 2004, 10:00 am - 12:00 pm1 Apr 2004V935: Novel Surgical Technique for the Treatment of Female Stress Urinary Incontinence: Transobturator Vaginal Tape Inside-Out Jean De Leval, Pierre Bonnet, Olivier Reul, and David Waltregny Jean De LevalJean De Leval More articles by this author , Pierre BonnetPierre Bonnet More articles by this author , Olivier ReulOlivier Reul More articles by this author , and David WaltregnyDavid Waltregny More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)39238-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "V935: Novel Surgical Technique for the Treatment of Female Stress Urinary Incontinence: Transobturator Vaginal Tape Inside-Out." The Journal of Urology, 171(4S), p. 248 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 248 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Jean De Leval More articles by this author Pierre Bonnet More articles by this author Olivier Reul More articles by this author David Waltregny More articles by this author Expand All Advertisement PDF downloadLoading ...