Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Comparison of Transobturator Tape and Single Incision Mini-sling Procedures in the Surgical Treatment of Stress Urinary Incontinence in Obese Women: Retrospective Cohort Study
Obez Kadınlardaki Stress Üriner İnkontinansın Cerrahi Tedavisinde Transobturator Bant ve Tek İnsizyon Mini-Sling Prosedürlerinin Karşılaştırılması: Retrospektif Kohort Çalışması
Kubilay SARIKAYAa, Çağrı ŞENOCAKa, Fahri Erkan SADİOĞLUa, Mehmet ÇİFTÇİa, Muhammed Arif İBİŞa, Ömer Faruk BOZKURTa
aDepartment of Urology, Health Sciences University Keçiören Training and Research Hospital Ankara, TURKEY
J Reconstr Urol. 2021;11(2):61-7
doi: 10.5336/urology.2021-82933
Article Language: EN
Full Text
ABSTRACT
 Objective: To compare the effectiveness of Transobturator tape (TOT) and Single incision mini-sling (SIMS) procedures in obese women, which are the most preferred methods in the surgical treatment of stres urinary incontinence (SUI). Material and Methods: The data of 96 female patients who underwent surgical treatment for SUI with a body mass index ≥35 kg/m2 in our clinic were retrospectively analyzed. The patients were divided into two groups as TOT (n=54) and SIMS (n=42) according to the surgical procedure applied. The preoperative and postoperative 1-h pad test results, International Consultation on Incontinence Qestionnaire scoring form (ICIQ-SF) and the Incontinence Quality of Life (IQO-L) results of the groups were compared. Results: The total objective cure rate was 77.1% according to the 1-h pad test at a median 26 (12-114) month follow-up. While a median increase of 1.70 (1.27-11.92) g weight gain was detected in the TOT group in the postoperative 1-h pad test, it was 1.75 (1.5-66.25) g in the SIMS group (p=0.049). While there was no difference between the groups in terms of improvement in the postoperative ICIQ-SF score (p=0.073), the TOT group was significantly more advantageous than the SIMS group in terms of improvement in the IQO-L score (p=0.003). Median operating time was 40 (30-45) min in the TOT group and 25 (20-30) min in the SIMS group (p<0.001). Subjective and objective cure rates were significantly higher in the TOT group than SIMS group (81.5% vs 61.9% p=0.032 and 85.2% vs 66.7% p=0.032, respectively). Conclusion: Despite the longer operating time, the TOT procedure is more advantageous than the SIMS procedure in terms of subjective cure, objective cure and increase in quality of life score in the surgical treatment of SUI in obese women.

Keywords: Urinary incontinence; suburethral slings; complications; quality of life
ÖZET
 Amaç: Stres üriner inkontinansın [stres urinary incontinence (SUI)] cerrahi tedavisinde en sık tercih edilen yöntemlerden olan transobturator bant [transobturator tape (TOT)] ve tek insizyon mini-sling [Single incision mini-sling (SIMS)] prosedürlerinin obez kadınlardaki etkinliğini inceleyerek, bu 2 yöntemin sonuçlarını karşılaştırmak. Gereç ve Yöntemler: Kliniğimizde SUI nedeniyle cerrahi tedavi yaptığımız beden kitle indeksi≥35 kg/m2 olan toplam 96 kadın hastanın verileri retrospektif olarak incelenmiştir. Hastalar uygulanan cerrahi prosedüre göre TOT (n=54) ve SIMS (n=42) olarak 2 gruba ayrılmıştır. Hastaların preoperatif ve postoperatif 1 saatlik ped testi sonuçları, Uluslar arası İnkontinans Konsültasyon Sorgulama Anketi-Kısa Form [International Consultation on Incontinence Qestionnaire scoring form (ICIQ-SF)] ve İnkontinans Yaşam Kalitesi Ölçeği [Incontinence Quality of Life (IQOL)] skorları belirlenerek gruplar karşılaştırılmıştır. Bulgular: Medyan 26 (12-114) aylık takipte 1 saatlik ped testine göre toplam objektif kür oranı %77,1 bulunmuştur. Postoperatif 1 saatlik ped testinde TOT grubunda medyan 1,70 (1,27-11,92) g ağılık artışı olurken SIMS grubunda medyan 1,75 (1,5-66,25) g ağırlık artışı olduğu saptanmıştır (p=0,049). Postoperatif ICIQ-SF skorundaki düzelme bakımından gruplar arasında fark bulunmazken (p=0,073) IQO-L skorundaki düzelme bakımından TOT grubunun SIMS grubundan anlamlı olarak avantajlı olduğu görülmüştür (p=0,003). Medyan operasyon süresinin TOT grubunda 40 (30-45) dk ve SIMS grubunda 25 (20-30) dk olduğu görülmüştür (p<0,001). Subjektif kür ve objektif kür oranları ise TOT grubunda SIMS grubundan anlamlı olarak yüksek bulunmuştur (sırasıyla %81,5 vs %61,9 p=0,032 ve %85,2 vs %66,7 p=0,032). Sonuç: Daha uzun operasyon süresine rağmen obez kadınlarda TOT prosedürü SIMS prosedürüne göre subjektif kür, objektif kür ve IQO-L skorundaki iyileşme bakımından daha avantajlıdır.

Anahtar Kelimeler: Üriner inkontinans; subüretral slingler; komplikasyonlar; yaşam kalitesi
REFERENCES:
  1. Sangsawang B, Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. 2013;24(6):901-12. [Crossref]  [PubMed]  [PMC] 
  2. Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Neurourol Urodyn. 2017;36(2):221-44. [Crossref]  [PubMed] 
  3. Kobashi KC, Albo ME, Dmochowski RR, Ginsberg DA, Goldman HB, Gomelsky A, et al. Surgical treatment of female stress urinary incontinence: AUA/SUFU Guideline. J Urol. 2017;198(4):875-83. [Crossref]  [PubMed] 
  4. Thüroff JW, Abrams P, Andersson KE, Artibani W, Chapple CR, Drake MJ, et al. EAU guidelines on urinary incontinence. Eur Urol. 2011;59(3):387-400. [Crossref]  [PubMed] 
  5. Morán E, Pérez-Ardavín J, Sánchez JV, Bonillo MA, Martínez-Cuenca E, Arlandis S, et al. Mid-term safety and efficacy of the ALTIS single-incision sling for female stress urinary incontinence: less mesh, same results. BJU Int. 2019;123(5A):E51-E6. [Crossref]  [PubMed] 
  6. Subak LL, Richter HE, Hunskaar S. Obesity and urinary incontinence: epidemiology and clinical research update. J Urol. 2009;182(6 Suppl):S2-7. [Crossref]  [PubMed]  [PMC] 
  7. Leanza V. Tension-free mini-invasive anti-incontinence procedures: Comparison among three main pathways. Open Women's Health Journal. 2012;6:30-5. [Crossref] 
  8. Moore RD, De Ridder D, Kennelly MJ. Two-year evaluation of the MiniArc in obese versus non-obese patients for treatment of stress urinary incontinence. Int J Urol. 2013;20(4):434-40. [Crossref]  [PubMed] 
  9. Jørgensen L, Lose G, Andersen JT. One-hour pad-weighing test for objective assessment of female urinary incontinence. Obstet Gynecol. 1987;69(1):39-42. [PubMed] 
  10. Cetinel B, Ozkan B, Can G. The validation study of ICIQ-SF Turkish version. Turkish J Urol. 2004;30:332-8. [Link] 
  11. Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn. 2007; 26(1):129-33. [Crossref]  [PubMed] 
  12. Delorme E. [Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women]. Prog Urol. 2001;11(6):1306-13. [PubMed] 
  13. Meschia M, Rossi G, Bertini S, Sommacal A, Foina S, Sandretti F, et al. Single incision mid-urethral slings: impact of obesity on outcomes. Eur J Obstet Gynecol Reprod Biol. 2013;170(2):571-4. [Crossref]  [PubMed] 
  14. Schimpf MO, Rahn DD, Wheeler TL, Patel M, White AB, Orejuela FJ, et al; Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014;211(1): 71.e1-71.e27. [Crossref]  [PubMed] 
  15. Karataş S, Tekelioğlu M, Temür M, Ender Yumru A. [The comparison of adjustable single-incision mini sling and transobturator tape for the treatment of stress urinary incontinance]. JAREM. 2020;10(1):36-40. [Crossref] 
  16. Chang CP, Chang WH, Hsu YM, Chen YJ, Wen KC, Chao KC, et al; Task Force on Gyn-Urodynamic Research Group. Comparison of single-incision mini-slings (Ajust) and standard transobturator midurethral slings (Align) in the management of female stress urinary incontinence: A 1-year follow-up. Taiwan J Obstet Gynecol. 2015;54(6):726-30. [Crossref]  [PubMed] 
  17. Zhang P, Fan B, Zhang P, Han H, Xu Y, Wang B, et al. Meta-analysis of female stress urinary incontinence treatments with adjustable single-incision mini-slings and transobturator tension-free vaginal tape surgeries. BMC Urol. 2015;15:64. [Crossref]  [PubMed]  [PMC] 
  18. Xia Z, Qian J, Chen Y, Liao B, Luo D. Does body mass index influence the outcome of midurethral sling procedures for stress urinary incontinence? Int Urogynecol J. 2017;28(6): 817-22. [Crossref]  [PubMed] 
  19. Frigerio M, Regini C, Manodoro S, Spelzini F, Milani R. Mini-sling efficacy in obese versus non-obese patients for treatment of stress urinary incontinence. Minerva Ginecol. 2017;69(6):533-7. [Crossref]  [PubMed] 
  20. Bach F, Hill S, Toozs-Hobson P. The effect of body mass index on retropubic midurethral slings. Am J Obstet Gynecol. 2019;220(4): 371.e1-371.e9. [Crossref]  [PubMed] 
  21. Anding R, Schoen M, Kirschner-Hermanns R, Fisang C, Müller SC, Latz S. Minimally invasive treatment of female stress urinary incontinence with the adjustable single-incision sling system (AJUST ?) in an elderly and overweight population. Int Braz J Urol. 2017;43(2): 280-8. d [Crossref]  [PubMed]  [PMC] 
  22. Lau HH, Enkhtaivan S, Su TH, Huang WC. The outcome of a single-ıncision sling versus trans-obturator sling in overweight and obese women with stress urinary ıncontinence at 3-year follow-up. J Clin Med. 2019;8(8):1099. [Crossref]  [PubMed]  [PMC] 
  23. Bayrak O, Seckiner I, Urgun G, Sen H, Ozcan C, Erturhan S. Transobturator midurethral slings versus single-ıncision slings for stress ıncontinence in overweight patients. Int Braz J Urol. 2015;41(4):714-21. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com