Purpose: To assess the effectiveness of a long-acting anesthetic injection into the obturator membrane for pain relief in women undergoing trans-obturator tension-free vaginal tape.
Methods: A total of 22 women were randomized for the intra-operative injection of bupivacaine into one of their obturator membranes: the left or right side. All the participants were asked to define their groin pain on a visual analog scale (scored 0-10 cm) at 1, 6, 12, and 24 h post-operative. For each woman, pain scores were compared between the local anesthetic-injected side and the opposite side.
Results: Statistically significant differences were not observed in groin pain scores between the bupivacaine injection side and the no injection side at 1 h (p = 0.76), 6 h (p = 1), 12 h (p = 0.95), and 24 h (p = 0.82) post-operative.
Conclusion: In women who undergo trans-obturator tension-free vaginal tape procedures, intra-operative intra-obturator injection of local anesthetics is not effective in alleviating the characteristic post-operative groin pain.
Trial Registration: This study is registered on ClinicalTrials.gov (NCT03479996).
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http://dx.doi.org/10.1007/s00404-024-07533-y | DOI Listing |
Arch Esp Urol
November 2024
Gynecology Department, Ningbo No. 2 Hospital, 315000 Ningbo, Zhejiang, China.
Fr J Urol
November 2024
Department of Obstetrics, Gynecology and Reproductive Medicine, Nantes University Hospital, 38, boulevard Jean-Monnet, 44000 Nantes, France. Electronic address:
Background: The French Health Authority (Haute Autorité de santé) and French scientific societies (Collège national des gynécologues et obstétriciens français) recommend the use of midurethral slings as the surgical treatment of choice for stress incontinence due to urethral hypermobility and failure of hygienic diet and pelvic rehabilitation. Within a year of implantation, almost 90% of patients no longer experience stress urinary incontinence. Despite their recognized efficacy, retropubic and/or trans-obturator midurethral sling can expose patients to potentially severe infectious complications.
View Article and Find Full Text PDFArch Esp Urol
June 2024
Department of Obstetrics and Gynecology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 317000 Taizhou, Zhejiang, China.
Objective: Meta-analysis was conducted to compare and evaluate the efficacy and safety of tension-free vaginal tape (TVT), outside-in trans-obturator tape (TOT), inside-out tension-free vaginal tape-obturator (TVT-O) and transvaginal tension-free urethral sling surgery (TVT-S) in the treatment of female stress urinary incontinence (SUI).
Methods: A computer-based systematic search of the PubMed, The Cochrane Library, Medline, Embase, Web of Science and ScienceDirect databases for randomised controlled trials (RCTs) comparing TVT, TOT, TVT-O and TVT-S for the treatment of SUI was performed from the time of library construction to November 2023. Two investigators performed data extraction and quality evaluation of the included RCTs, extracting information including the follows: First author, time of publication, intervention, sample size, age, duration of follow-up and objective cure rate, subjective cure rate, dyspareunia, vaginal mucosal perforation, urinary tract infection, sling exposure and postoperative thigh pain/groin pain.
J Gynecol Obstet Hum Reprod
October 2024
Department of Obstetrics and Gynecology, Helsingborg, Sweden; Institution of Clinical Sciences, Dept. of Obstetrics and Gynecology, Lund University, Lund, Sweden. Electronic address:
Urinary incontinence affects 25-45 % of women with the gold standard surgical approach being placement of mid-urethral synthetic slings; tension-free vaginal tape (TVT) and trans-obturator tape (TOT). Due to the controversies regarding vaginal mesh the last decade, an increasing demand has evolved for incontinence treatment without vaginal synthetic mesh. The short term results of autologous rectus fascia sling for TOT surgery have shown similar success rates compared to those after the use of synthetic mesh, but the harvesting of the mesh is less minimally invasive and is associated with longer surgical time.
View Article and Find Full Text PDFArch Gynecol Obstet
September 2024
Bahçeşehir University, VM Medical Park Maltepe Hospital, Clinic of Obstetrics and Gynecology, Istanbul, Turkey.
Objective: To compare needleless mini-slings placed in a retropubic (U-shape) or trans-obturator (hammock-shape) configuration for treating stress urinary incontinence at 60th month.
Methods: All surgeries, conducted by a senior surgeon, involved objective and subjective assessments preoperatively and at 6, 12, 18, and 60 months postoperatively using cough-stress tests, ICIQ-SF, PGI-I, and a Likert scale.
Results: After 60 months, no significant differences were found in cure rates, mesh complications, or reinterventions between U-shaped and hammock-shaped groups.
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