7th SEEM: obturator tapes yield benefits in female SUI
Tuesday, 18 October 2011- Obturator tapes are recommended for treating female stress urinary incontinence (SUI) as shown in evidence-based studies which also demonstrate that obturator tapes are not only as good as retropubic tapes but also provide less adverse effects.
"Evidence-based research has shown that obturator tapes are as efficient as retropubic tapes and with the added benefit that obturator tapes have less bladder perforation," said Prof. Walter Artibani during a state-of-the-art lecture on the surgical treatment of female SUI he gave at the EAU 7th South Eastern European Meeting (SEEM) held over the weekend in Skopje.
Artibani added that retropubic tape is better than the Burch colposuspension approach and that retropubic tapes have similar benefits as pubovaginal (PV) slings but with less post-operative storage lower urinary tract symptoms (LUTS).
In his overview lecture, Artibani also compared and weigh the benefits and drawbacks between tension-free vaginal tape (TVT) versus the transobturator tape. "There are higher objective continence rates with TVT, although there is no difference in subjective continence rates," Artibani explained.
He, however, noted that studies have shown that there is a higher risk of intraoperative complications with TVT (such as bladder or vaginal perforations, postoperative hematoma) and that storage LUTS are slightly more common after a TVT procedure.
Artibani said that in the last decade actual clinical practices have shown that the use of Burch and autologous slings have declined in recent years compared to mid-urethral tapes.
"The clinical experience and the perception of those starting a programme of mid-urethral tapes were very clear: these (tapes) have higher efficacy, are less invasive and with less sequelae," he noted.
In his closing remarks Artibani said that for index patients the obturator tape is recommended, while for selected patients the retropubic tape yields benefit. "For patients with sphincter failure the pubovaginal sling is the suggested approach" he added.