Transobturator tension free vaginal tapes

Are they the way forward in the surgical treatment of urodynamic stress incontinence?

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives
The transobturator approach for sub-urethral tension free vaginal tapes had gained wide popularity in surgical treatment of urodynamic stress incontinence over the last few years. This study aims to survey the practice and preferences of urogynaecologists and urologists worldwide as regards the transobturator tapes.

Material and methods
Seven hundred and twenty surgeons worldwide were surveyed via postal/email questionnaire about their views and practice regarding the transobturator tape procedures (TOTs). They were asked about their technique and tape material preference and their reasons for choosing them. They were also asked about every detail of the procedure.

Results
Adjusted response rate was 68%. Of the responding surgeons, 97% were well aware of the TOTs and only 44.3% undertake them. While 34.16% of the surgeons thought that TOTs are the way forward in the treatment of USI, 14.84% surgeons disagreed and the majority (51%) are yet to decide. With regards to technique of TOTs, most surgeons (38%) would prefer to use both techniques, while 34% use “In–Out” technique only and 28% use “Out–In” technique only. The vast majority (72%) use polypropylene mesh tapes due to better tissue incorporation and proven safety records. A few surgeons deviate from the originally described TOTs; 13.6% use a catheter guide to deviate the bladder and urethra during the trochar insertion and 31.41% use routine cystoscopy as part of the procedure.

Conclusion
Whilst one-third of the responding surgeons think that the transobturator approach for tension free vaginal tapes is the way forward for the management of USI, the majority are awaiting studies with longer-term results. The variation from the originally described TOT procedures seems to be inherited from the TVT™ procedure.

Original languageEnglish
Pages (from-to)3-10
Number of pages8
JournalInternational Journal of Surgery
Volume5
Issue number1
Early online date14 Feb 2006
DOIs
Publication statusPublished - Feb 2007

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Suburethral Slings
Urodynamics
Therapeutics
Cystoscopy
Polypropylenes
Urethra
Surgeons
Urinary Bladder
Catheters
Safety

Keywords

  • urodynamic stress incontinence
  • transobturator tapes
  • TVT

Cite this

@article{2e83633151ff4e189f69c4da0c4c124d,
title = "Transobturator tension free vaginal tapes: Are they the way forward in the surgical treatment of urodynamic stress incontinence?",
abstract = "Objectives The transobturator approach for sub-urethral tension free vaginal tapes had gained wide popularity in surgical treatment of urodynamic stress incontinence over the last few years. This study aims to survey the practice and preferences of urogynaecologists and urologists worldwide as regards the transobturator tapes. Material and methods Seven hundred and twenty surgeons worldwide were surveyed via postal/email questionnaire about their views and practice regarding the transobturator tape procedures (TOTs). They were asked about their technique and tape material preference and their reasons for choosing them. They were also asked about every detail of the procedure. Results Adjusted response rate was 68{\%}. Of the responding surgeons, 97{\%} were well aware of the TOTs and only 44.3{\%} undertake them. While 34.16{\%} of the surgeons thought that TOTs are the way forward in the treatment of USI, 14.84{\%} surgeons disagreed and the majority (51{\%}) are yet to decide. With regards to technique of TOTs, most surgeons (38{\%}) would prefer to use both techniques, while 34{\%} use “In–Out” technique only and 28{\%} use “Out–In” technique only. The vast majority (72{\%}) use polypropylene mesh tapes due to better tissue incorporation and proven safety records. A few surgeons deviate from the originally described TOTs; 13.6{\%} use a catheter guide to deviate the bladder and urethra during the trochar insertion and 31.41{\%} use routine cystoscopy as part of the procedure. Conclusion Whilst one-third of the responding surgeons think that the transobturator approach for tension free vaginal tapes is the way forward for the management of USI, the majority are awaiting studies with longer-term results. The variation from the originally described TOT procedures seems to be inherited from the TVT™ procedure.",
keywords = "urodynamic stress incontinence, transobturator tapes, TVT",
author = "Mohamed Abdel-Fattah and I Ramsay",
year = "2007",
month = "2",
doi = "10.1016/j.ijsu.2005.12.002",
language = "English",
volume = "5",
pages = "3--10",
journal = "International Journal of Surgery",
issn = "1743-9159",
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T1 - Transobturator tension free vaginal tapes

T2 - Are they the way forward in the surgical treatment of urodynamic stress incontinence?

AU - Abdel-Fattah, Mohamed

AU - Ramsay, I

PY - 2007/2

Y1 - 2007/2

N2 - Objectives The transobturator approach for sub-urethral tension free vaginal tapes had gained wide popularity in surgical treatment of urodynamic stress incontinence over the last few years. This study aims to survey the practice and preferences of urogynaecologists and urologists worldwide as regards the transobturator tapes. Material and methods Seven hundred and twenty surgeons worldwide were surveyed via postal/email questionnaire about their views and practice regarding the transobturator tape procedures (TOTs). They were asked about their technique and tape material preference and their reasons for choosing them. They were also asked about every detail of the procedure. Results Adjusted response rate was 68%. Of the responding surgeons, 97% were well aware of the TOTs and only 44.3% undertake them. While 34.16% of the surgeons thought that TOTs are the way forward in the treatment of USI, 14.84% surgeons disagreed and the majority (51%) are yet to decide. With regards to technique of TOTs, most surgeons (38%) would prefer to use both techniques, while 34% use “In–Out” technique only and 28% use “Out–In” technique only. The vast majority (72%) use polypropylene mesh tapes due to better tissue incorporation and proven safety records. A few surgeons deviate from the originally described TOTs; 13.6% use a catheter guide to deviate the bladder and urethra during the trochar insertion and 31.41% use routine cystoscopy as part of the procedure. Conclusion Whilst one-third of the responding surgeons think that the transobturator approach for tension free vaginal tapes is the way forward for the management of USI, the majority are awaiting studies with longer-term results. The variation from the originally described TOT procedures seems to be inherited from the TVT™ procedure.

AB - Objectives The transobturator approach for sub-urethral tension free vaginal tapes had gained wide popularity in surgical treatment of urodynamic stress incontinence over the last few years. This study aims to survey the practice and preferences of urogynaecologists and urologists worldwide as regards the transobturator tapes. Material and methods Seven hundred and twenty surgeons worldwide were surveyed via postal/email questionnaire about their views and practice regarding the transobturator tape procedures (TOTs). They were asked about their technique and tape material preference and their reasons for choosing them. They were also asked about every detail of the procedure. Results Adjusted response rate was 68%. Of the responding surgeons, 97% were well aware of the TOTs and only 44.3% undertake them. While 34.16% of the surgeons thought that TOTs are the way forward in the treatment of USI, 14.84% surgeons disagreed and the majority (51%) are yet to decide. With regards to technique of TOTs, most surgeons (38%) would prefer to use both techniques, while 34% use “In–Out” technique only and 28% use “Out–In” technique only. The vast majority (72%) use polypropylene mesh tapes due to better tissue incorporation and proven safety records. A few surgeons deviate from the originally described TOTs; 13.6% use a catheter guide to deviate the bladder and urethra during the trochar insertion and 31.41% use routine cystoscopy as part of the procedure. Conclusion Whilst one-third of the responding surgeons think that the transobturator approach for tension free vaginal tapes is the way forward for the management of USI, the majority are awaiting studies with longer-term results. The variation from the originally described TOT procedures seems to be inherited from the TVT™ procedure.

KW - urodynamic stress incontinence

KW - transobturator tapes

KW - TVT

U2 - 10.1016/j.ijsu.2005.12.002

DO - 10.1016/j.ijsu.2005.12.002

M3 - Article

VL - 5

SP - 3

EP - 10

JO - International Journal of Surgery

JF - International Journal of Surgery

SN - 1743-9159

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ER -