Transobturator versus single incision slings: 1-year results of a randomized controlled trial

Aimee L. Tieu, Aparna Hegde, Peter A. Castillo, G. Willy Davila, Vivian Aguilar

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction and Hypothesis: To compare 1-year surgical outcomes following transobturator (TO) sling placement and single incision (SI) sling placement for the treatment of stress urinary incontinence (SUI). Methods: We performed a randomized trial at a single institution. Patients with urodynamically proven SUI were offered participation and randomized to placement of a TO sling (Monarc™) or a SI sling (MiniArc™) between 2008 and 2011. The primary outcome measure was urinary leakage during standardized cough stress test (CST). Forty subjects in each group were required to achieve 80 % power to detect an effect size of 0.25. Results: A total of 98 patients were randomized with 49 patients in the TO group and 49 patients in the SI group. Preoperative demographics were similar between the groups (Table 1). The TO group had a significantly longer sling operative time (10.7 ± 4.8 min vs. 7.8 ± 4.9 min, p < 0.001) and greater estimated blood loss (31.6 ± 26.6 mL vs. 22.9 ± 22.1 mL, p = 0.02). At the 1-year follow-up, there was no difference in the primary outcome with 9 TO patients (21 %) and 12 SI patients (29 %) having a positive CST (p = 0.5). A composite measurement of ‘failure’, defined as patient-reported SUI and a positive CST, showed no difference between the TO group (17 %) and the SI group (27 %; p = 0.3). Conclusions: The SI sling provides comparable objective efficacy to the TO sling at 1 year.

Original languageEnglish (US)
Pages (from-to)461-467
Number of pages7
JournalInternational Urogynecology Journal
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Randomized Controlled Trials
Stress Urinary Incontinence
Exercise Test
Cough
Operative Time
Demography
Outcome Assessment (Health Care)

Keywords

  • Single incision slings
  • Stress incontinence
  • Transobturator slings

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

Cite this

Transobturator versus single incision slings : 1-year results of a randomized controlled trial. / Tieu, Aimee L.; Hegde, Aparna; Castillo, Peter A.; Davila, G. Willy; Aguilar, Vivian.

In: International Urogynecology Journal, Vol. 28, No. 3, 01.03.2017, p. 461-467.

Research output: Contribution to journalArticle

Tieu, Aimee L. ; Hegde, Aparna ; Castillo, Peter A. ; Davila, G. Willy ; Aguilar, Vivian. / Transobturator versus single incision slings : 1-year results of a randomized controlled trial. In: International Urogynecology Journal. 2017 ; Vol. 28, No. 3. pp. 461-467.
@article{09b641d721f6462cb26123fb4db675ea,
title = "Transobturator versus single incision slings: 1-year results of a randomized controlled trial",
abstract = "Introduction and Hypothesis: To compare 1-year surgical outcomes following transobturator (TO) sling placement and single incision (SI) sling placement for the treatment of stress urinary incontinence (SUI). Methods: We performed a randomized trial at a single institution. Patients with urodynamically proven SUI were offered participation and randomized to placement of a TO sling (Monarc™) or a SI sling (MiniArc™) between 2008 and 2011. The primary outcome measure was urinary leakage during standardized cough stress test (CST). Forty subjects in each group were required to achieve 80 {\%} power to detect an effect size of 0.25. Results: A total of 98 patients were randomized with 49 patients in the TO group and 49 patients in the SI group. Preoperative demographics were similar between the groups (Table 1). The TO group had a significantly longer sling operative time (10.7 ± 4.8 min vs. 7.8 ± 4.9 min, p < 0.001) and greater estimated blood loss (31.6 ± 26.6 mL vs. 22.9 ± 22.1 mL, p = 0.02). At the 1-year follow-up, there was no difference in the primary outcome with 9 TO patients (21 {\%}) and 12 SI patients (29 {\%}) having a positive CST (p = 0.5). A composite measurement of ‘failure’, defined as patient-reported SUI and a positive CST, showed no difference between the TO group (17 {\%}) and the SI group (27 {\%}; p = 0.3). Conclusions: The SI sling provides comparable objective efficacy to the TO sling at 1 year.",
keywords = "Single incision slings, Stress incontinence, Transobturator slings",
author = "Tieu, {Aimee L.} and Aparna Hegde and Castillo, {Peter A.} and Davila, {G. Willy} and Vivian Aguilar",
year = "2017",
month = "3",
day = "1",
doi = "10.1007/s00192-016-3128-z",
language = "English (US)",
volume = "28",
pages = "461--467",
journal = "International Urogynecology Journal and Pelvic Floor Dysfunction",
issn = "0937-3462",
publisher = "Springer London",
number = "3",

}

TY - JOUR

T1 - Transobturator versus single incision slings

T2 - 1-year results of a randomized controlled trial

AU - Tieu, Aimee L.

AU - Hegde, Aparna

AU - Castillo, Peter A.

AU - Davila, G. Willy

AU - Aguilar, Vivian

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Introduction and Hypothesis: To compare 1-year surgical outcomes following transobturator (TO) sling placement and single incision (SI) sling placement for the treatment of stress urinary incontinence (SUI). Methods: We performed a randomized trial at a single institution. Patients with urodynamically proven SUI were offered participation and randomized to placement of a TO sling (Monarc™) or a SI sling (MiniArc™) between 2008 and 2011. The primary outcome measure was urinary leakage during standardized cough stress test (CST). Forty subjects in each group were required to achieve 80 % power to detect an effect size of 0.25. Results: A total of 98 patients were randomized with 49 patients in the TO group and 49 patients in the SI group. Preoperative demographics were similar between the groups (Table 1). The TO group had a significantly longer sling operative time (10.7 ± 4.8 min vs. 7.8 ± 4.9 min, p < 0.001) and greater estimated blood loss (31.6 ± 26.6 mL vs. 22.9 ± 22.1 mL, p = 0.02). At the 1-year follow-up, there was no difference in the primary outcome with 9 TO patients (21 %) and 12 SI patients (29 %) having a positive CST (p = 0.5). A composite measurement of ‘failure’, defined as patient-reported SUI and a positive CST, showed no difference between the TO group (17 %) and the SI group (27 %; p = 0.3). Conclusions: The SI sling provides comparable objective efficacy to the TO sling at 1 year.

AB - Introduction and Hypothesis: To compare 1-year surgical outcomes following transobturator (TO) sling placement and single incision (SI) sling placement for the treatment of stress urinary incontinence (SUI). Methods: We performed a randomized trial at a single institution. Patients with urodynamically proven SUI were offered participation and randomized to placement of a TO sling (Monarc™) or a SI sling (MiniArc™) between 2008 and 2011. The primary outcome measure was urinary leakage during standardized cough stress test (CST). Forty subjects in each group were required to achieve 80 % power to detect an effect size of 0.25. Results: A total of 98 patients were randomized with 49 patients in the TO group and 49 patients in the SI group. Preoperative demographics were similar between the groups (Table 1). The TO group had a significantly longer sling operative time (10.7 ± 4.8 min vs. 7.8 ± 4.9 min, p < 0.001) and greater estimated blood loss (31.6 ± 26.6 mL vs. 22.9 ± 22.1 mL, p = 0.02). At the 1-year follow-up, there was no difference in the primary outcome with 9 TO patients (21 %) and 12 SI patients (29 %) having a positive CST (p = 0.5). A composite measurement of ‘failure’, defined as patient-reported SUI and a positive CST, showed no difference between the TO group (17 %) and the SI group (27 %; p = 0.3). Conclusions: The SI sling provides comparable objective efficacy to the TO sling at 1 year.

KW - Single incision slings

KW - Stress incontinence

KW - Transobturator slings

UR - http://www.scopus.com/inward/record.url?scp=84990857084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84990857084&partnerID=8YFLogxK

U2 - 10.1007/s00192-016-3128-z

DO - 10.1007/s00192-016-3128-z

M3 - Article

C2 - 27714435

AN - SCOPUS:84990857084

VL - 28

SP - 461

EP - 467

JO - International Urogynecology Journal and Pelvic Floor Dysfunction

JF - International Urogynecology Journal and Pelvic Floor Dysfunction

SN - 0937-3462

IS - 3

ER -