Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective Study

Zhuo Jiang,1 Chaoyan Yuan2 1Department of Medical School, Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, People’s Republic of China; 2Department of Gynecology, Minda Hospital of Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, Peopl...

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Main Authors: Jiang Z, Yuan C
Format: Article
Language:English
Published: Dove Medical Press 2024-11-01
Series:International Journal of Women's Health
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Online Access:https://www.dovepress.com/comparative-analysis-of-the-efficacy-of-different-surgical-modalities--peer-reviewed-fulltext-article-IJWH
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author Jiang Z
Yuan C
author_facet Jiang Z
Yuan C
author_sort Jiang Z
collection DOAJ
description Zhuo Jiang,1 Chaoyan Yuan2 1Department of Medical School, Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, People’s Republic of China; 2Department of Gynecology, Minda Hospital of Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, People’s Republic of ChinaCorrespondence: Chaoyan Yuan, Email 2569537144@qq.comObjective: To compare the efficacy of autologous fascial retropubic midurethral sling, anterior vaginal wall epithelial flap midurethral suspension, tension-free vaginal tape-obturator and adjustable urethral suspension with a single incision for the treatment of female stress urinary incontinence.Materials and Methods: A total of 243 SUI patients who were admitted to Minda Hospital of Hubei Minzu University, were chosen and split into four groups based on various surgical techniques: the AFS group (59 cases), TVT-O group (61 cases), epithelial flap group (62 cases) and ASIS group (61 cases). A comparison of four patient groups’ quality-of-life scores, urodynamic indices, urethral structure-related indices before and a year after treatment, complication rates and perioperative-related indices.Results: There was no discernible difference in the treatment outcomes among the four groups(P> 0.05). However, the ASIS group exhibited significantly reduced intraoperative hemorrhage, hospitalization duration and operative time compared to the mucosal flap and TVT-O groups(P< 0.05). Both the TVT-O and ASIS groups demonstrated significantly higher hospitalization expenditures than the mucosal flap and AFS groups (P< 0.05). No significant differences were observed in postoperative indwelling catheterization, IIQ-7 and I-QOL ratings, urodynamic indices or urethral structure-related indexes across the four patient groups(P> 0.05). The TVT-O group showed a significantly higher incidence of postoperative medial thigh pain compared to the AFS, mucosal flap, and ASIS groups(P< 0.05). Similarly, the AFS group had a significantly greater incidence of postoperative urine retention compared to the mucosal flap, TVT-O, and ASIS groups(P< 0.05).Conclusion: While all four surgical techniques demonstrated good efficacy and improved patients’ quality of life, our study suggests that TVT-O had a significantly higher incidence of post-treatment medial thigh pain and ASIS may be a safer and less problematic surgical approach for the treatment of female SUI. This has important therapeutic implications.Keywords: mid-urethral slings, stress urinary incontinence, tension-free vaginal tape, Urethral Slings
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spelling doaj-art-09ab97cac5e94c7f9862ca063206c1152024-12-01T16:41:11ZengDove Medical PressInternational Journal of Women's Health1179-14112024-11-01Volume 162051206397830Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective StudyJiang ZYuan CZhuo Jiang,1 Chaoyan Yuan2 1Department of Medical School, Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, People’s Republic of China; 2Department of Gynecology, Minda Hospital of Hubei Minzu University, Enshi, Enshi Tujia and Miao Autonomous Prefecture, Hubei, People’s Republic of ChinaCorrespondence: Chaoyan Yuan, Email 2569537144@qq.comObjective: To compare the efficacy of autologous fascial retropubic midurethral sling, anterior vaginal wall epithelial flap midurethral suspension, tension-free vaginal tape-obturator and adjustable urethral suspension with a single incision for the treatment of female stress urinary incontinence.Materials and Methods: A total of 243 SUI patients who were admitted to Minda Hospital of Hubei Minzu University, were chosen and split into four groups based on various surgical techniques: the AFS group (59 cases), TVT-O group (61 cases), epithelial flap group (62 cases) and ASIS group (61 cases). A comparison of four patient groups’ quality-of-life scores, urodynamic indices, urethral structure-related indices before and a year after treatment, complication rates and perioperative-related indices.Results: There was no discernible difference in the treatment outcomes among the four groups(P> 0.05). However, the ASIS group exhibited significantly reduced intraoperative hemorrhage, hospitalization duration and operative time compared to the mucosal flap and TVT-O groups(P< 0.05). Both the TVT-O and ASIS groups demonstrated significantly higher hospitalization expenditures than the mucosal flap and AFS groups (P< 0.05). No significant differences were observed in postoperative indwelling catheterization, IIQ-7 and I-QOL ratings, urodynamic indices or urethral structure-related indexes across the four patient groups(P> 0.05). The TVT-O group showed a significantly higher incidence of postoperative medial thigh pain compared to the AFS, mucosal flap, and ASIS groups(P< 0.05). Similarly, the AFS group had a significantly greater incidence of postoperative urine retention compared to the mucosal flap, TVT-O, and ASIS groups(P< 0.05).Conclusion: While all four surgical techniques demonstrated good efficacy and improved patients’ quality of life, our study suggests that TVT-O had a significantly higher incidence of post-treatment medial thigh pain and ASIS may be a safer and less problematic surgical approach for the treatment of female SUI. This has important therapeutic implications.Keywords: mid-urethral slings, stress urinary incontinence, tension-free vaginal tape, Urethral Slingshttps://www.dovepress.com/comparative-analysis-of-the-efficacy-of-different-surgical-modalities--peer-reviewed-fulltext-article-IJWHmid-urethral slings;stress urinary incontinencetension-free vaginal tape;urethral slings
spellingShingle Jiang Z
Yuan C
Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective Study
International Journal of Women's Health
mid-urethral slings;stress urinary incontinence
tension-free vaginal tape;urethral slings
title Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective Study
title_full Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective Study
title_fullStr Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective Study
title_full_unstemmed Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective Study
title_short Comparative Analysis of the Efficacy of Different Surgical Modalities for the Treatment of Female Stress Urinary Incontinence: A Multicenter Retrospective Study
title_sort comparative analysis of the efficacy of different surgical modalities for the treatment of female stress urinary incontinence a multicenter retrospective study
topic mid-urethral slings;stress urinary incontinence
tension-free vaginal tape;urethral slings
url https://www.dovepress.com/comparative-analysis-of-the-efficacy-of-different-surgical-modalities--peer-reviewed-fulltext-article-IJWH
work_keys_str_mv AT jiangz comparativeanalysisoftheefficacyofdifferentsurgicalmodalitiesforthetreatmentoffemalestressurinaryincontinenceamulticenterretrospectivestudy
AT yuanc comparativeanalysisoftheefficacyofdifferentsurgicalmodalitiesforthetreatmentoffemalestressurinaryincontinenceamulticenterretrospectivestudy