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Surgical intervention for stress urinary incontinence: comparison of midurethral sling procedures
Joseph M Novi1, Beth H K Mulvihill
1Urogynecology and Reconstructive Pelvic Surgery, Riverside Methodist Hospital, 3545 Olentangy River Rd, North Medical Building, Suite 501, Columbus, OH 43214-3908, USA. jnovi@ohiohealth.com
Context:
The synthetic, tension-free midurethral sling was introduced in the 1990s as a surgical treatment for women with stress urinary incontinence (SUI). Several similar products are now available. The authors generated data comparing clinical outcomes of two midurethral sling procedures.
Objective:
To compare clinical outcomes of two midurethral sling procedures currently used for the treatment of women with SUI: Gynecare Tension-free Vaginal Tape (TVT; Ethicon Women's Health & Urology, Somerville, NJ) and Uretex Self-Anchoring Urethral Support System (CR Bard Inc, Covington, Ga).
Methods:
A nonrandomized, prospective study was conducted at a urogynecology practice with women who had preoperative urodynamically proven SUI. The study consisted of two phases: 100 consecutive cases using the TVT midurethral sling, then 100 consecutive cases using the Uretex midurethral sling. Symptom improvement was evaluated at 12-month postoperative follow-up by measuring rates of prolonged intermittent self-catheterization, urinary tract infection, urinary retention requiring urethrolysis, and new-onset urge incontinence.
Results:
The TVT and Uretex groups were similar with respect to age, parity, and incidence of prior anti-incontinence surgery. There was no significant difference in outcomes measured between the two groups in symptom improvement at 12-month follow-up.
Conclusion:
The TVT and Uretex midurethral slings demonstrate similar short-term improvement and complication rates in a nonrandomized population of women with SUI.
