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A COMPARISON OF THE OUTCOMES WITH “SURGEON-TAILORED” MESH VERSUS INDUSTRIAL KITS IN TRANSOBTURATOR TAPE SURGERY Fikret F. Ö nol , Fettah Tosun, M. Serdar Buğday, Uğur Boylu, Eyüp V. Küçük, Eyüp Gümüş Ümraniye Training and Research Hospital, Urology, Istanbul, Turkey . ABSTRACT NO: 1203535.

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A COMPARISON OF THE OUTCOMES WITH “SURGEON-TAILORED” MESH VERSUS INDUSTRIAL KITS IN TRANSOBTURATOR TAPE SURGERY Fikret F. Önol,Fettah Tosun, M. Serdar Buğday, Uğur Boylu, Eyüp V. Küçük, Eyüp GümüşÜmraniye Training and Research Hospital, Urology, Istanbul, Turkey

ABSTRACT NO: 1203535

  • RESULTS :
  • Demographic characteristics and preoperative ICIQ-SF scores were similar between the groups (table 1).
  • Follow-up in the 1st group was significantly longer (table 2, p<0.001). At the last visit, there was no significant difference between the 2 groups in terms of the success of stress incontinence treatment (table2, 89.3% vs. 93.3%).
  • Subjective resolution of preoperative urge symptoms was significantly higher in group 2 (table 2).
  • De-novo urge symptoms developed in similar rates between the 2 groups (20% vs. 25%, p>0.05).

Table 2 : The outcomes of “surgeon-tailored” mesh (group 1) and industrial kit (group 2) groups for TOT surgery at the last follow-up (* Student’s t-test, † Pearson chi-square test).

OBJECTIVES:

  • The costs of commercial kits for transobturator tape (TOT) have limited their use in several health systems.
  • In this study, we evaluated the outcomes of a TOT procedure done with “surgeon-tailored” mesh.

MATERIALS AND METHODS:

  • Between January 2007 and May 2011, 92 women underwent outside-in TOT treatment for stress or stress predominant mixed incontinence.
  • A 1.cm-wide strip tailored from a 30x30 cm. polypropylene mesh (Gal-Mesh™, Gallini medical devices, Mantova, Italy) was used as sling in group 1 (Figure 1, n=47) and a commercial kit (Safyre-tTM, Promedon medical devices, Cordoba, Argentina) was used in group 2 (n=45)
  • All patients underwent subjective assessment of the impact of voiding symptoms with International Consultation on Incontinence Questionnaire (ICIQ-SF), physical examination with a cough test, urinalysis, uroflowmetry and urinary tract ultrasound.
  • Voiding and incontinence symptoms, and complications were prospectively assessed at 1, 3, 6, and 12 months postoperatively, and yearly thereafter

Table 1: Demographiccharacteristics of “surgeon-tailored” mesh (group 1) and industrial kit (group 2) groups for TOT surgery at the last follow-up (* t-test, † Pearson chi-square test).

  • Vaginal mesh erosion occured significantly higher in group 2 (0 vs. 6.6%, p<0.001)
  • One and 2 patients with respect to groups required mesh incision in the first postoperative month because of obstructive symptoms.
  • CONCLUSIONS :
  • Surgeon-tailored”polypropylene mesh seems as a safe and effective sling material for TOT surgery.