Korean J Urol.  2010 Apr;51(4):223-232.

The Evolution of Surgical Treatment for Female Stress Urinary Incontinence: Era of Mid-Urethral Slings

• Lee YS
• Lee HN
• Lee KS

Abstract

Based on the integral theory, tension-free placement of a mid-urethral sling (MUS) for female stress urinary incontinence (SUI) has gained substantial popularity owing to the ease of the procedure and its effectiveness. Published series with long-term follow-up show continence rates after the MUS procedure ranging from 70% to 80%. Complication rates after MUS procedures are usually low. This review aimed to describe the historical change and the current use of the MUS. We discuss the efficacy and complications of various MUS procedures and the current strategies for managing failed slings.

Keyword

Stress urinary incontinence; Tension-free vaginal tape; Trans-obturator tape

MeSH Terms

Animals
Female
Follow-Up Studies
Humans
Mice
Suburethral Slings
Urinary Incontinence

Figure

• 

  FIG. 1 TVT-Secur device after insertion. (A) TVT-Secur "U" type. (B) TVT-Secur "H" type (Figures printed with permission from TVT-S; TVT-Secur, Gynecare, Menlo Park, CA, USA).

Reference

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

2. Petros PEP, Woodman PJ. The integral theory of continence. Int Urogynecol J Pelvic Floor Dysfunct. 2008. 19:35–40.

3. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996. 7:81–85.

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

5. Doo CK, Hong B, Chung BJ, Kim JY, Jung HC, Lee KS, et al. Five-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence. Eur Urol. 2006. 50:333–338.

6. Juang CM, Yu KJ, Chou P, Yen MS, Twu NF, Horng HC, et al. Efficacy analysis of trans-obturator tension-free vaginal tape (TVT-O) plus modified Ingelman-Sundberg procedure versus TVT-O alone in the treatment of mixed urinary incontinence: a randomized study. Eur Urol. 2007. 51:1671–1678.

7. Davila GW, Johnson JD, Serels S. Multicenter experience with the Monarc transobturator sling system to treat stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2006. 17:460–465.

8. Bai SW, Sohn WH, Chung DJ, Park JH, Kim SK. Comparison of the efficacy of Burch colposuspension, pubovaginal sling, and tension-free vaginal tape for stress urinary incontinence. Int J Gynaecol Obstet. 2005. 91:246–251.

9. Wadie BS, Edwan A, Nabeeh AM. Autologous fascial sling vs polypropylene tape at short-term followup: A prospective randomized study. J Urol. 2005. 174:990–993.

10. Novara G, Ficarra V, Boscolo-Berto R, Secco S, Cavalleri S, Artibani W. Tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of Randomized controlled trials of effectiveness. Eur Urol. 2007. 52:663–679.

11. Rechberger T, Rzezniczuk K, Skorupski P, Adamiak A, Tomaszewski J, Baranowski W, et al. A randomized comparison between monofilament and multifilament tapes for stress incontinence surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2003. 14:432–436.

12. Meschia M, Pifarotti P, Bernasconi F, Magatti F, Vigano R, Bertozzi R, et al. Tension-free vaginal tape (TVT) and intravaginal slingplasty (IVS) for stress urinary incontinence: a multicenter randomized trial. Am J Obstet Gynecol. 2006. 195:1338–1342.

13. Tseng LH, Wang AC, Lin YH, Li SJ, Ko YJ. Randomized comparison of the suprapubic arc sling procedure vs tension-free vaginal taping for stress incontinent women. Int Urogynecol J Pelvic Floor Dysfunct. 2005. 16:230–235.

14. Gandhi S, Abramov Y, Kwon C, Beaumont JL, Botros S, Sand PK, et al. TVT versus SPARC: comparison of outcomes for two midurethral tape procedures. Int Urogynecol J Pelvic Floor Dysfunct. 2006. 17:125–130.

15. Enzelsberger H, Schalupny J, Heider R, Mayer G. TVT versus TOT - A prospective randomized study for the treatment of female stress urinary incontinence at a follow-up of 1 year. Geburtshilfe Und Frauenheilkunde. 2005. 65:506–511.

16. Laurikainen E, Valpas A, Kivela A, Kalliola T, Rinne K, Takala T, et al. Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2007. 109:4–11.

17. Lee KS, Han DH, Choi YS, Yum SH, Song SH, Doo CK, et al. A prospective trial comparing tension-free vaginal tape and transobturator vaginal tape inside-out for the surgical treatment of female stress urinary incontinence: 1-year follow up. J Urol. 2007. 177:214–218.

18. Latthe PM, Foon R, Toozs-Hobson P. Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis effectiveness and complications. BJOG. 2007. 114:522–531.

19. Lee KS, Choo MS, Lee YS, Han JY, Kim JY, Jung BJ, et al. Prospective comparison of the inside-out and outside-in transobturator-tape procedures for the treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008. 19:577–582.

20. Debodinance P. Trans-obturator urethral sling for the surgical correction of female stress urinary incontinence: outside-in (Monarc) versus inside-out (TVT-O). Are the two ways reassuring? Eur J Obstet Gynecol Reprod Biol. 2007. 133:232–238.

21. Lee KS, Lee YS, Seo JT, Na YG, Choo MS, Kim JC, et al. A prospective multicenter randomized comparative study between the U- and H-type methods of the TVT Secur procedure for the treatment of female stress urinary incontinence: 1-Year follow-up. Eur Urol. 2010. Epub ahead of print.

22. Meschia M, Barbacini P, Ambrogi V, Pifarotti P, Ricci L, Spreafico L. TVT-secur: a minimally invasive procedure for the treatment of primary stress urinary incontinence. One year data from a multi-centre prospective trial. Int Urogynecol J Pelvic Floor Dysfunct. 2009. 20:313–317.

23. Zullo MA, Plotti F, Calcagno M, Marullo E, Palaia I, Bellati F, et al. One-year follow-up of tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: A prospective randomised trial. Eur Urol. 2007. 51:1376–1384.

24. deTayrac R, Deffieux X, Droupy S, Chauveaud-Lambling A, Calvanese-Benamour L, Fernandez H. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol. 2004. 190:602–608.

25. Maroto JR, Gorraiz MO, Chaparro LP, Bru JJP, Bueno JJM, Lopez CL. Transvaginal adjustable tape: an adjustable mesh for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008. 19:1109–1116.

26. Maroto JR, Gorraiz MO, Bueno JJM, Perez LG, Bru JJP, Chaparro LP. Transobturator adjustable tape (TOA) permits to correct postoperatively the tension applied in stress incontinence surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2009. 20:797–805.

27. Rezapour M, Ulmsten U. Tension-Free vaginal tape (TVT) in women with mixed urinary incontinence-a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct. 2001. 12:Suppl 2. S15–S18.

28. Segal JL, Vassallo B, Kleeman S, Silva WA, Karram MM. Prevalence of persistent and de novo overactive bladder symptoms after the tension-free vaginal tape. Obstet Gynecol. 2004. 104:1263–1269.

29. Paick JS, Oh SJ, Kim SW, Ku JH. Tension-free vaginal tape, suprapubic arc sling, and transobturator tape in the treatment of mixed urinary incontinence in women. Int Urogynecol J Pelvic Floor Dysfunct. 2008. 19:123–129.

30. Artibani W. Cardozo L, Staskin L, editors. Complications of surgery for stress incontinence. Textbook of female urology and urogynecology. 2007. 2nd ed. Taylor & Francis Ltd;1345–1362.

31. Novara G, Galfano A, Boscolo-Berto R, Secco S, Cavalleri S, Ficarra V, et al. Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol. 2008. 53:288–308.

32. Lim YN, Muller R, Corstiaans A, Dietz HP, Barry C, Rane A. Suburethral slingplasty evaluation study in North Queensland, Australia: the SUSPEND trial. Aust N Z J Obstet Gynaecol. 2005. 45:52–59.

33. Andonian S, Chen T, St-Denis B, Corcos J. Randomized clinical trial comparing suprapubic arch sling (SPARC) and tension-free vaginal tape (TVT): one-year results. Eur Urol. 2005. 47:537–541.

34. Lord HE, Taylor JD, Finn JC, Tsokos N, Jeffery JT, Atherton MJ, et al. A randomized controlled equivalence trial of short-term complications and efficacy of tension-free vaginal tape and suprapubic urethral support sling for treating stress incontinence. BJU Int. 2006. 98:367–376.

35. Neuman M. Perioperative complications and early follow-up with 100 TVT-SECUR procedures. J Minim Invasive Gynecol. 2008. 15:480–484.

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

37. Morey AF, Medendorp AR, Noller MW, Mora RV, Shandera KC, Foley JP, et al. Transobturator versus transabdominal mid urethral slings: a multi-institutional comparison of obstructive voiding complications. J Urol. 2006. 175:1014–1017.

38. Minassian VA, Al-Badr A, Drutz HP, Lovatsis D. Tension-free vaginal tape, Burch, and slings: are there predictors for early postoperative voiding dysfunction? Int Urogynecol J Pelvic Floor Dysfunct. 2004. 15:183–187.

39. Karram MM, Segal JL, Vassallo BJ, Kleeman SD. Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol. 2003. 101:929–932.

40. Dorflinger A, Monga A. Voiding dysfunction. Curr Opin Obstet Gynecol. 2001. 13:507–512.

41. Haab F, Sananes S, Amarenco G, Ciofu C, Uzan S, Gattegno B, et al. Results of the tension-free vaginal tape procedure for the treatment of type II stress urinary incontinence at a minimum followup of 1 year. J Urol. 2001. 165:159–162.

42. Moran PA, Ward KL, Johnson D, Smirni WE, Hilton P, Bibby J. Tension-free vaginal tape for primary genuine stress incontinence: a two-centre follow-up study. BJU Int. 2000. 86:39–42.

43. Song C, Park SH, Han JY, Lee KS, Choo MS. Identification of the optimal time to treat urgency after a midurethral sling procedure for stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008. 19:573–576.

44. Liapis A, Bakas P, Creatsas G. Tension-free vaginal tape in the management of recurrent urodynamic stress incontinence after previous failed midurethral tape. Eur Urol. 2009. 55:1450–1455.

45. Lee KS, Doo CK, Han DH, Jung BJ, Han JY, Choo MS. Outcomes following repeat mid urethral synthetic sling after failure of the initial sling procedure: rediscovery of the tension-free vaginal tape procedure. J Urol. 2007. 178:1370–1374.

46. Tsivian A, Neuman M, Yulish E, Shtricker A, Levin S, Cytron S, et al. Redo midurethral synthetic sling for female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2007. 18:23–26.

47. Moore RD, Gamble K, Miklos JR. Tension-free vaginal tape sling for recurrent stress incontinence after transobturator tape sling failure. Int Urogynecol J Pelvic Floor Dysfunct. 2007. 18:309–313.

48. Liapis A, Bakas P, Lazaris D, Creatsas G. Tension-free vaginal tape in the management of recurrent stress incontinence. Arch Gynecol Obstet. 2004. 269:205–207.

49. Azam U, Frazer MI, Kozman EL, Ward K, Hilton P, Rane A. The tension-free vaginal tape procedure in women with previous failed stress incontinence surgery. J Urol. 2001. 166:554–556.

50. Rardin CR, Kohli N, Rosenblatt PL, Miklos JR, Moore R, Strohsnitter WC. Tension-free vaginal tape: outcomes among women with primary versus recurrent stress urinary incontinence. Obstet Gynecol. 2002. 100:893–897.

51. Lo TS, Horng SG, Chang CL, Huang HJ, Tseng LH, Liang CC. Tension-free vaginal tape procedure after previous failure in incontinence surgery. Urology. 2002. 60:57–61.

52. Kuuva N, Nilsson CG. Tension-free vaginal tape procedure: an effective minimally invasive operation for the treatment of recurrent stress urinary incontinence? Gynecol Obstet Invest. 2003. 56:93–98.

53. Petrou SP, Frank I. Complications and initial continence rates after a repeat pubovaginal sling procedure for recurrent stress urinary incontinence. J Urol. 2001. 165:1979–1981.

54. Blaivas JG, Jacobs BZ. Pubovaginal fascial sling for the treatment of complicated stress urinary incontinence. J Urol. 1991. 145:1214–1218.

55. Breen JM, Geer BE, May GE. The fascia lata suburethral sling for treating recurrent urinary stress incontinence. Am J Obstet Gynecol. 1997. 177:1363–1365.

56. Lightner D, Calvosa C, Andersen R, Klimberg I, Brito CG, Snyder J, et al. A new injectable bulking agent for treatment of stress urinary incontinence: results of a multicenter, randomized, controlled, double-blind study of Durasphere. Urology. 2001. 58:12–15.

57. Nguyen JK. Diagnosis and treatment of voiding dysfunction caused by urethral obstruction after anti-incontinence surgery. Obstet Gynecol Surv. 2002. 57:468–475.

58. Pfisterer MH, Griffiths DJ, Rosenberg L, Schaefer W, Resnick NM. Parameters of bladder function in pre-, peri-, and postmenopausal continent women without detrusor overactivity. Neurourol Urodyn. 2007. 26:356–361.

59. Suebnukanwattana T, Lohsiriwat S, Chaikomin R, Tantiwongse A, Soontrapa S. Uroflowmetry in normal Thai subjects. J Med Assoc Thai. 2003. 86:353–360.

60. Al-Shahrani M, Lovatsis D. Do subjective symptoms of obstructive voiding correlate with post-void residual urine volume in women? Int Urogynecol J Pelvic Floor Dysfunct. 2005. 16:12–14.

61. Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn. 2000. 19:553–564.

62. Massolt ET, Groen J, Vierhout ME. Application of the Blaivas-Groutz bladder outlet obstruction nomogram in women with urinary incontinence. Neurourol Urodyn. 2005. 24:237–242.

63. Hammad FT, Kennedy-Smith A, Robinson RG. Erosions and urinary retention following polypropylene synthetic sling: Australasian survey. Eur Urol. 2005. 47:641–646.

64. Abouassaly R, Steinberg JR, Lemieux M, Marois C, Gilchrist LI, Bourque JL, et al. Complications of tension-free vaginal tape surgery: a multi-institutional review. BJU Int. 2004. 94:110–113.

65. Campeau L, Al-Afraa T, Corcos J. Evaluation and management of urinary retention after a suburethral sling procedure in women. Curr Urol Rep. 2008. 9:412–418.

66. Glavind K, Glavind E. Treatment of prolonged voiding dysfunction after tension-free vaginal tape procedure. Acta Obstet Gynecol Scand. 2007. 86:357–360.

67. Zubke W, Becker S, Kramer B, Wallwiener D. Persistent urinary retention after tension-free vaginal tape: a new surgical solution. Eur J Obstet Gynecol Reprod Biol. 2004. 115:95–98.

68. Croak AJ, Schulte V, Peron S, Klingele C, Gebhart J, Lee R. Transvaginal tape lysis for urinary obstruction after tension-free vaginal tape placement. J Urol. 2003. 169:2238–2241.

69. Rardin CR, Rosenblatt PL, Kohli N, Miklos JR, Heit M, Lucente VR. Release of tension-free vaginal tape for the treatment of refractory postoperative voiding dysfunction. Obstet Gynecol. 2002. 100:898–902.

70. Klutke C, Siegel S, Carlin B, Paszkiewicz E, Kirkemo A, Klutke J. Urinary retention after tension-free vaginal tape procedure: incidence and treatment. Urology. 2001. 58:697–701.