TVTPain reduction after anti-incontinence operation with a shortened sub-mid urethral sling implant and medial needle trajectory

• Published in: Pelviperineology 2016-03, Vol.35 (1), p.10
• Main Authors: Gilad, Reut, Neuman, Menahem, Bornstein, Jacob
• Format: Article
• Language: eng ; ita
• Subjects: Pain
• ISSN: 1973-4905; 1973-4913

Aim of the study: We wanted to evaluate the 3 year-efficacy and the reduction in incidence, durability and severity of post-operative pain after trans-obturator sub mid urethral sling implantation with sling shortening and needle trajectory by medial route vs. results in previous studies reported in the medical literature of similar surgery using the Tension-free vaginal tape trans-obturator method. Methods: In this retrospective study, 82 patients’ pre and post-operative data was collected from the medical records and by a telephone interview questionnaire regarding relief of symptoms and post-operative complications, focusing on post-operative pain. Results: Of the eighty two participants, most reported very low incidence and severity of post-operative pain. Two patients (2%) had post-operative moderate dyspareunia, while four patients (3.6%) suffered significant post-operative overactive bladder symptoms. Previously reported data regarding the trans-obturator sub mid urethral sling procedure showed that 11.5% and up to 30% of operated patients suffered post-operative pain, mainly at the thigh, pelvis and vagina, lasting for an average of two weeks. Some had chronic intractable thigh pain related to obturator neuralgia. Surgical attempts to remove the implant failed to improve the outcome. The operative cure rates shown here, evaluated by SUI symptoms persistence, were similar to those previously reported with the trans-obturator sub mid urethral sling procedure. Conclusion: The short sub mid urethral sling, positioned according to the FF method, is shown to lower the post-operative pain, while maintaining similar efficiency with SUI cure.