AUGS/IUGA Scientific Meeting 2019-Long Oral Session 2

Video Transcription

Video Summary

A trial comparing two techniques for tensioning retropubic slings was conducted. One technique used Mayo scissors in the suburethral space, while the other used a fixed loop of tape 14 millimeters long using a Babcock clamp. The trial aimed to determine which technique was superior. The primary outcome was abnormal bladder function, which was a composite of bothersome stress urinary incontinence or overactive bladder, a positive cough stress test, retreatment for stress urinary incontinence, or postoperative urinary retention. The trial included 318 women across four centers in Western Canada. The two techniques had similar operative times, but there were some differences in outcomes. The scissor tensioning group had a higher rate of catheterization at discharge and longer duration of catheterization, but a lower rate of mesh exposure. The primary outcome was met by 30% of the scissor group and 18% of the Babcock group, mainly driven by a higher rate of positive cough stress tests and urinary retention in the scissor group. Secondary outcomes showed slightly lower peak flow rates and higher post-void residuals in the scissor group, as well as more prescriptions for OAB medications. Overall, the two techniques had similar rates of stress urinary incontinence cure, but differed in the rate of urinary retention and mesh exposure. The trial results suggested that each technique had advantages and disadvantages, and surgeons should consider these when deciding which technique to use.

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Katherine Hartmann, MD, PhD, Tomi S. Mikkola, MD, Erin A. Brennand, MD, Lore Schierlitz, MD, FRANZCOG, CU, Jennifer M. Wu, MD, MPH, David Rapp, MD, Vivian W. Sung, MD, MPH

Keywords

trial

techniques

tensioning

retropubic slings

Mayo scissors

Babcock clamp

bladder function

stress urinary incontinence

operative times

mesh exposure