Poster, Podium & Video Sessions
Presentation Authors: Dmitry Shkarupa*, Alexey Pisarev, Nikita Kubin, Anastasia Zaytseva, Olga Staroseltseva, Saint-Petersburg, Russian Federation
Introduction: Suburethral sling procedure is common and the most effective technique in treating female stress urinary incontinence (SUI). Obstructive voiding is one of the most common problems of sling surgery, its frequency is on average 7,3% (0-33,9). In 2,3% cases surgical intervention is required. The aim of the study was to evaluate the efficacy and safety of adjustable midurethral tape for surgical treatment of SUI.
Methods: Our prospective study included 212 women, suffering from SUI. All patiens underwent transobturator adjustable midurethral tape (UroSling, Lintex) placement. This tape can be adjusted during 2 days after surgery by tighting (pulling up the ends of the tape left uncut) or loosing (pulling down the central part of the tape by special ligatures). The pre- and postoperative evaluation included history taking, validated questionnaires (UDI-6, UIQ-6, PFIQ-7, I-QOL, ICIQ-SF, VAS), vaginal examination, cough stress test, uroflowmetry, bladder ultrasound and measurement of post-void residual urine volume, 24-hours Pad-test.
Results: Mean operation time was 14,6 minutes. No patients had intraoperative bladder injury or clinically significant bleeding. One day after surgery 30,18% (n=64) women required tape tension adjustment, 25% (n=16) of them had obstructive flow pattern, Qmax<12 ml/s and post-void residual urine volume was more than 100 ml. After tension adjustment none of the patients had any signs of obstructive voiding.
After 12-month follow-up there were no significant decrease of Qmax and average flowrate (p<0,05). No cases of obstructive voiding, urinary retention, vaginal mesh extrusion or wound infection were detected. De novo urgency and urgent urinary incontinence appeared in 9 (4,24%) and 2 (0,94%) patients respectively. The objective cure rate was 92,45% (n=196) and 3,77% (n=8) of women noted a significant improvement, although in 8 (3,77%) patients operation was ineffective. The subjective cure rate according to questionnaires was 93,86% (n=207).
Conclusions: Transobturator adjustable midurethral tape proved to be high effective and safe method of treating women with SUI. It demonstrated low rate of intra- and postoperative complications and significantly decreased the risk of infravesical obstruction development compared with traditional methods.
Source Of Funding: None
Saint-Petersburg State University Medical Centre
Dmitry D. Shkarupa, MD, PhD, Saint-Petersburg State University, grew up in Russia and received his MD degree from the Military Medical Academy (St.-Petersburg) in 2006. After he obtained his PhD degree from the Urology Clinic of Military Medical Academy in 2009, he became the chairman of Urology Department of the North-Western Regional Medical Center of Ministry of Healthcare, that was transformed recently to the Medical Center of Saint-Petersburg state University. In 2010 Dr. Shkarupa developed North-Western Centre of pelviperineology that is now one of the busiest clinics specialized on women health in Russia. Today more then 1500 pelvic floor surgeries for SUI and POP are performed in this center of reference annually. Dr. Shkarupa is the expert in development new synthetic mesh products and POP repair technologies.
Friday, May 12
8:20 AM – 8:30 AM