How common are tape erosions? A comparison of two versions of the transobturator tension-free vaginal tape procedure

Mohamed Abdel-Fattah, Kanapathippillai Sivanesan, Ian Ramsay, Stewart Pringle, Stein Bjornsson

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

OBJECTIVE: To compare two transobturator suburethral tapes (Obtape, Mentor-Porges and TVT-O, Gynaecare, Johnson and Johnson) used in the management of urodynamic stress incontinence (USI), for tape erosion (vaginal/urethral) rates, clinical presentation, management and outcome. PATIENTS AND METHODS: We retrospectively studied women who underwent a transobturator suburethral tension-free vaginal tape (TVT) procedure for managing USI in a tertiary referral centre in the West of Scotland over a 36-month period. In our department, the transobturator approach has been the first-choice approach for TVTs since July 2003. Two types of tapes were mainly used, Obtape and TVT-O, and the choice of tape was primarily decided by the surgeons' preference. RESULTS: In all, 316 women had a transobturator tape procedure, of which 96 were associated with another procedure; 112 women had TVT-O using the 'inside-out' technique and 204 had the 'outside-in' technique. Of the latter, 192 had Obtape, four had Obtryx (Boston Scientific) and eight had Monarc (American Medical Systems Inc.) tapes. Sixteen women developed vaginal tape erosion, and significantly more were in the Obtape group than in the TVT-O group (7.29% vs 1.78%, P = 0.038). The patients' age, body mass index, previous vaginal surgery and concomitant vaginal surgery were not significant risk factors for erosions. The time between surgery and diagnosis of erosion was 1-45 weeks, with only one patient being asymptomatic; all others presented with clinical symptoms such as vaginal bleeding, discharge and dyspareunia. Thirteen patients were continent at presentation and 10 of these remained continent after surgical management. In the TVT-O group the erosions were in the lateral vaginal wall, while in the Obtape group the erosions were in the form of central tape extrusion secondary to defective vaginal wall healing. CONCLUSION: There were significantly more vaginal tape erosions in the Obtape group than in the TVT-O group. No cases of urethral erosions were identified.
Original languageEnglish
Pages (from-to)594-598
Number of pages5
JournalBJU International
Volume98
Issue number3
DOIs
Publication statusPublished - 1 Sep 2006

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Suburethral Slings
Urodynamics
Dyspareunia
Vaginal Discharge
Mentors
Uterine Hemorrhage
Scotland
Tertiary Care Centers
Body Mass Index

Keywords

  • Chi-Square Distribution
  • Female
  • Humans
  • Middle Aged
  • Prostheses and Implants
  • Reoperation
  • Retrospective Studies
  • Surgical Mesh
  • Urinary Incontinence, Stress
  • Urodynamics
  • Vagina

Cite this

How common are tape erosions? A comparison of two versions of the transobturator tension-free vaginal tape procedure. / Abdel-Fattah, Mohamed; Sivanesan, Kanapathippillai; Ramsay, Ian; Pringle, Stewart; Bjornsson, Stein.

In: BJU International, Vol. 98, No. 3, 01.09.2006, p. 594-598.

Research output: Contribution to journalArticle

Abdel-Fattah, Mohamed ; Sivanesan, Kanapathippillai ; Ramsay, Ian ; Pringle, Stewart ; Bjornsson, Stein. / How common are tape erosions? A comparison of two versions of the transobturator tension-free vaginal tape procedure. In: BJU International. 2006 ; Vol. 98, No. 3. pp. 594-598.
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abstract = "OBJECTIVE: To compare two transobturator suburethral tapes (Obtape, Mentor-Porges and TVT-O, Gynaecare, Johnson and Johnson) used in the management of urodynamic stress incontinence (USI), for tape erosion (vaginal/urethral) rates, clinical presentation, management and outcome. PATIENTS AND METHODS: We retrospectively studied women who underwent a transobturator suburethral tension-free vaginal tape (TVT) procedure for managing USI in a tertiary referral centre in the West of Scotland over a 36-month period. In our department, the transobturator approach has been the first-choice approach for TVTs since July 2003. Two types of tapes were mainly used, Obtape and TVT-O, and the choice of tape was primarily decided by the surgeons' preference. RESULTS: In all, 316 women had a transobturator tape procedure, of which 96 were associated with another procedure; 112 women had TVT-O using the 'inside-out' technique and 204 had the 'outside-in' technique. Of the latter, 192 had Obtape, four had Obtryx (Boston Scientific) and eight had Monarc (American Medical Systems Inc.) tapes. Sixteen women developed vaginal tape erosion, and significantly more were in the Obtape group than in the TVT-O group (7.29{\%} vs 1.78{\%}, P = 0.038). The patients' age, body mass index, previous vaginal surgery and concomitant vaginal surgery were not significant risk factors for erosions. The time between surgery and diagnosis of erosion was 1-45 weeks, with only one patient being asymptomatic; all others presented with clinical symptoms such as vaginal bleeding, discharge and dyspareunia. Thirteen patients were continent at presentation and 10 of these remained continent after surgical management. In the TVT-O group the erosions were in the lateral vaginal wall, while in the Obtape group the erosions were in the form of central tape extrusion secondary to defective vaginal wall healing. CONCLUSION: There were significantly more vaginal tape erosions in the Obtape group than in the TVT-O group. No cases of urethral erosions were identified.",
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T1 - How common are tape erosions?

T2 - A comparison of two versions of the transobturator tension-free vaginal tape procedure

AU - Abdel-Fattah, Mohamed

AU - Sivanesan, Kanapathippillai

AU - Ramsay, Ian

AU - Pringle, Stewart

AU - Bjornsson, Stein

PY - 2006/9/1

Y1 - 2006/9/1

N2 - OBJECTIVE: To compare two transobturator suburethral tapes (Obtape, Mentor-Porges and TVT-O, Gynaecare, Johnson and Johnson) used in the management of urodynamic stress incontinence (USI), for tape erosion (vaginal/urethral) rates, clinical presentation, management and outcome. PATIENTS AND METHODS: We retrospectively studied women who underwent a transobturator suburethral tension-free vaginal tape (TVT) procedure for managing USI in a tertiary referral centre in the West of Scotland over a 36-month period. In our department, the transobturator approach has been the first-choice approach for TVTs since July 2003. Two types of tapes were mainly used, Obtape and TVT-O, and the choice of tape was primarily decided by the surgeons' preference. RESULTS: In all, 316 women had a transobturator tape procedure, of which 96 were associated with another procedure; 112 women had TVT-O using the 'inside-out' technique and 204 had the 'outside-in' technique. Of the latter, 192 had Obtape, four had Obtryx (Boston Scientific) and eight had Monarc (American Medical Systems Inc.) tapes. Sixteen women developed vaginal tape erosion, and significantly more were in the Obtape group than in the TVT-O group (7.29% vs 1.78%, P = 0.038). The patients' age, body mass index, previous vaginal surgery and concomitant vaginal surgery were not significant risk factors for erosions. The time between surgery and diagnosis of erosion was 1-45 weeks, with only one patient being asymptomatic; all others presented with clinical symptoms such as vaginal bleeding, discharge and dyspareunia. Thirteen patients were continent at presentation and 10 of these remained continent after surgical management. In the TVT-O group the erosions were in the lateral vaginal wall, while in the Obtape group the erosions were in the form of central tape extrusion secondary to defective vaginal wall healing. CONCLUSION: There were significantly more vaginal tape erosions in the Obtape group than in the TVT-O group. No cases of urethral erosions were identified.

AB - OBJECTIVE: To compare two transobturator suburethral tapes (Obtape, Mentor-Porges and TVT-O, Gynaecare, Johnson and Johnson) used in the management of urodynamic stress incontinence (USI), for tape erosion (vaginal/urethral) rates, clinical presentation, management and outcome. PATIENTS AND METHODS: We retrospectively studied women who underwent a transobturator suburethral tension-free vaginal tape (TVT) procedure for managing USI in a tertiary referral centre in the West of Scotland over a 36-month period. In our department, the transobturator approach has been the first-choice approach for TVTs since July 2003. Two types of tapes were mainly used, Obtape and TVT-O, and the choice of tape was primarily decided by the surgeons' preference. RESULTS: In all, 316 women had a transobturator tape procedure, of which 96 were associated with another procedure; 112 women had TVT-O using the 'inside-out' technique and 204 had the 'outside-in' technique. Of the latter, 192 had Obtape, four had Obtryx (Boston Scientific) and eight had Monarc (American Medical Systems Inc.) tapes. Sixteen women developed vaginal tape erosion, and significantly more were in the Obtape group than in the TVT-O group (7.29% vs 1.78%, P = 0.038). The patients' age, body mass index, previous vaginal surgery and concomitant vaginal surgery were not significant risk factors for erosions. The time between surgery and diagnosis of erosion was 1-45 weeks, with only one patient being asymptomatic; all others presented with clinical symptoms such as vaginal bleeding, discharge and dyspareunia. Thirteen patients were continent at presentation and 10 of these remained continent after surgical management. In the TVT-O group the erosions were in the lateral vaginal wall, while in the Obtape group the erosions were in the form of central tape extrusion secondary to defective vaginal wall healing. CONCLUSION: There were significantly more vaginal tape erosions in the Obtape group than in the TVT-O group. No cases of urethral erosions were identified.

KW - Chi-Square Distribution

KW - Female

KW - Humans

KW - Middle Aged

KW - Prostheses and Implants

KW - Reoperation

KW - Retrospective Studies

KW - Surgical Mesh

KW - Urinary Incontinence, Stress

KW - Urodynamics

KW - Vagina

U2 - 10.1111/j.1464-410X.2006.06348.x

DO - 10.1111/j.1464-410X.2006.06348.x

M3 - Article

C2 - 16925759

VL - 98

SP - 594

EP - 598

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 3

ER -