New Single-Incision Sling System MiniArc in treatment of the female stress urinary incontinence

Česká verzia

Authors: O. Šottner; M. Halaška; K. Maxová; J. Vláčil; D. Kolařík; J. Chaloupecký; K. Hurt; J. Záhumenský; B. Zmrhalová; J. Vojtěch
Authors place of work: Gynekologicko-porodnická klinika 1. LF UK a FN Na Bulovce, Praha, přednosta prof. MUDr. M. Halaška, DrSc.
Published in the journal: Ceska Gynekol 2010; 75(2): 101-104

Summary

Objective:
The aim of this paper is to introduce the new Single-Incision Sling System MiniArc in treatment of the female stress urinary incontinence.

Subject:
Prospective follow up.

Setting:
Department of Obstetrics and Gynaecology, The First Faculty of Medicine, Charles University in Prague.

Subject and method:
Prospective follow up of the first set of 38 patients treated with the new method MiniArc.

Conclusion:
We performed initial 38 cases of MiniArc under the local anesthesia. There was neither the complication during procedure, nor during the early postoperative period. No patient required urine derivation. Late postoperative period showed neither obstruction, nor „de novo urgency“. One asymptomatic sub-urethral tape protrusion into the vagina was found. No late postoperative pain occurred. Subjective cure rate was investigated in 33 ladies with follow up from 6 weeks through 19 months. 23 females declared full dryness (i. e. 76.7%), 6 patients were very satisfied and declared improvement of more than 70% (i. e. 20.0%); thus we obtained efficacy in 29 cases of 30 (i. e. 96.7%). We have not seen any vanishing of the sling effect. Based on our initial experience we judge the new single incision tape as very promising.

Key words:
urogynaecology, implant, tape, stress urinary incontinence, single incision sling, tension free vaginal tape, MiniArc.

Zdroje

1. Amid, PK., Lichtenstein, IL., Shulman, AG., Hakakha, M. Biomaterials for “tension-free” hernioplasties and principles of their applications. Minerva Chir 1995, 50, p. 821-826.

2. Burch, JC. Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele, and prolapse. Am J Obstet Gynecol 1961, 81, p. 281-290.

3. De, LJ. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 2003, 44, p. 724-730.

4. Debodinance, P., Amblard, J., Lucot, JP., et al. TVT Secur: prospective study and follow up at 1 year about 154 patients. J Gynecol Obstet Biol Reprod 2009, 38, p. 299-303.

5. Delorme, E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001, 11, p. 1306-1313.

6. Krofta, L., Feyereisl, J., Otčenasek, M., et al. TVT and TVT-O for surgical treatment of primary stress urinary incontinence: prospective randomized trial. Int Urogynecol J Pelvic Floor Dysfunct 2009.

7. Lim, YN., Dwyer, PL. Effectiveness of midurethral slings in intrinsic sphincteric-related stress urinary incontinence. Curr Opin Obstet Gynecol 2009, 21, p. 428-433.

8. Martan, A., Mašata, J., Švabik, K. TVT SECUR System—tension-free support of the urethra in women suffering from stress urinary incontinence—technique and initial experience. Čes Gynek 2007, 72, p. 42-49.

9. Nilsson, CG., Palva, K., Rezapour, M., Falconer, C. Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2008, 19, p. 1043-1047.

10. Petros, PE., Ulmsten, UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl 1990, 153, p. 7-31.

11. Rinne, K., Laurikainen, E., Kivela, A., et al. A randomized trial comparing TVT with TVT-O: 12-month results. Int Urogynecol J Pelvic Floor Dysfunct 2008, 19, p. 1049-1054.

12. Ward, KL., Hilton, P. A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: two-year follow-up. Am J Obstet Gynecol 2004, 190, p. 324-331.

13. Ward, KL., Hilton, P. Tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5‑year follow up. BJOG 2008, 115, p. 226-233.