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Abstract
Purpose
We compared the efficacy and vaginal erosion rates between a polypropylene multifilament tape (anterior intravaginal slingplasty; IVS) and a polypropylene monofilament tape (tension free vaginal tape; TVT) as surgical implants for suburethral, tension-free tape for the treatment of stress urinary incontinence (SUI).
Materials and Methods
We retrospectively reviewed the women (n=272) who underwent an anterior IVS (n=142) or a TVT (n=130) procedure for managing SUI, between January 2004 and December 2005 at Cheil General Hospital. Only 216 patients (the anterior IVS group: 112, the TVT group: 104) with a follow-up of at least 24 months were included in this study. Preoperatively, each patient received a history review, a physical examination, a voiding diary, a pad test, uroflowmetry and determination of the postvoid residual urine. Follow-up evaluations were performed at 1 month, 3 months and annually after the operation.
Results
The two groups were similar for their preoperative characteristics. There was no significant difference between the 2 groups in terms of the cure rate: cure (89.29% vs. 89.42%, respectively, p=0.974), improvement (6.25% vs. 7.69%, respectively, p=0.677), and failure (4.46% vs. 2.89%, respectively, p=0.539) for the anterior IVS and TVT groups, respectively. Nine women developed vaginal erosion, and this occurred significantly more in the anterior IVS group than the TVT group (7.14% vs. 0.96%, respectively, p=0.036).
Conclusions
Anterior IVS and TVT appear to be equally effective for the surgical treatment of female SUI. However the number of women who were diagnosed with vaginal erosion was significantly higher in the anterior IVS group than in the TVT group. It is possible that the multifilamentous nature of the anterior IVS tape might contribute to vaginal erosion.
Figures and Tables
Table 4
Analysis of clinical features of 216 patients with stress urinary incontinence undergoing synthetic sling procedures
*, †: Nine women developed vaginal erosion, with significantly more in the anterior IVS group than the TVT group (7.14% vs. 0.96%, p=0.036). IVS: intravaginal slingplasty, TVT: tension-free vaginal tape, BMI: body mass index, AR: anterior colporraphy, PR: posterior colporraphy, DM: diabetes mellitus
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