background preloader

SLING -TVT- TOT

Facebook Twitter

Transobturator Slings: End of the Road. 2017 Abstract #490 Muscle - Sparing Transobturator Sling Removal In Patients with Refractory Pain. Delayed vaginal and urethral mesh exposure: 10 years after TVT surgery. - PubMed - NCBI. Patients’ perspectives on urethral bulk injection therapy and mid-urethral sling surgery for stress urinary incontinence. TVT: seventeen year follow up and the shrinking denominator effect. The shrinking denominator enhances the effect size and misleads the reader into thinking the effect is better than it actually is.

TVT: seventeen year follow up and the shrinking denominator effect

Carl Heneghan I am at the Ideal Conference, at a workshop talking about clinical trial reporting and recent surgical scandals. I chose the 17 years follow-up of the Tension-free Vaginal Tape – often quoted – as one example of the significant problems with long-term outcome reporting. Here is what the Oxford Clinical Commissioning Group report: ‘it confers a high prospect of long term cure (published 17 year data shows 70-80% long term efficacy) with a low risk of complication;’ the Cochrane review on mid-urethral review reports: ‘Observational studies of MUS show data confirming effectiveness in the long term with some data that cover 15 to 17 years’ and a literature review on De Novo Urgency reports: ‘the reported success rates for this procedure are high, results reported at seventeen year’s follow up indicate a 90% objective cure.’ Sound good, doesn’t it? UGSA 2018 Debate - Dr Marcus Carey.

AQUIRE Expansion Focuses on SUI Surgery - President's Perspective - News. Bilateral Recurrent Thigh Abscesses for Five Years after a Transobturator Tape Implantation for Stress Urinary Incontinence. Shin Young Lee,Joon Young Kim,Se Joon Park,Yong Wook Kwon,Hoai Bac Nguyen,In Ho Chang,Tae Hyoung Kim and Young Sun Kim Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.

Bilateral Recurrent Thigh Abscesses for Five Years after a Transobturator Tape Implantation for Stress Urinary Incontinence

Corresponding Author: Young Sun Kim. Department of Urology, Chung-Ang University College of Medicine, 65-207, Hangangro 3-ga, Yongsan-gu, Seoul 140-757, Korea. TEL: +82-2-748-9578, FAX: +82-2-798-8577, Email: kthlmk@hanafos.com Received April 30, 2010; Accepted June 30, 2010. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract. Darmperforatie bij het plaatsen van een tensievrij vaginaal bandje wegens stressincontinentie. Complications following vaginal mesh procedures for stress urinary incontinence: an 8 year study of 92,246 women. Data source Records from English National Health Service (NHS) database of Admitted Patient Care (including day-cases)19 were extracted (on 26th November 2015) from HES.

Complications following vaginal mesh procedures for stress urinary incontinence: an 8 year study of 92,246 women

All data extraction and analyses were carried out in accordance with relevant guidelines and regulations. Pseudonymised episode-level HES data were provided by NHS Digital to the Newcastle upon Tyne Hospitals NHS Foundation Trust under Data Sharing Framework Contract CON-313204-B3P1Y and Data Sharing Agreement HDIS-DSC-0109. In accordance with the terms of these agreements, only aggregated totals of patients and procedures are reported and no identifiable information was available for analysis. This research involved only previously collected, non-identifiable information and did not require review by a UK Research Ethics Committee. Study design and population. Informed consent checklists for midurethral slings: a common-sense approach. - PubMed - NCBI.

Complications following vaginal mesh procedures for stress urinary incontinence: an 8 year study of 92,246 women. Data source Records from English National Health Service (NHS) database of Admitted Patient Care (including day-cases)19 were extracted (on 26th November 2015) from HES.

Complications following vaginal mesh procedures for stress urinary incontinence: an 8 year study of 92,246 women

All data extraction and analyses were carried out in accordance with relevant guidelines and regulations. Ws29 literature11. Adverse Events over Two Years after Retropubic or Transobturator Midurethral Sling Surgery: Findings from the Trial of Midurethral Sling (TOMUS) Study. Safety considerations for synthetic sling surgery : Nature Reviews Urology : Nature Research. Implantation of a synthetic midurethral sling (SMUS) is the most commonly performed anti-incontinence operation in women worldwide.

Safety considerations for synthetic sling surgery : Nature Reviews Urology : Nature Research

The effectiveness of the SMUS is comparable to that of the historical gold standards—autologous fascial slings and the Burch colposuspension. Much controversy, however, has evolved regarding the safety of this type of sling. Overall, the quality of the studies with respect to assessing risks of SMUS-associated complications is currently poor. The most common risks in patients with SMUS include urethral obstruction requiring surgery (2.3% of patients with SMUS), vaginal, bladder and/or urethral erosion requiring surgery (1.8%) and refractory chronic pain (4.1%); these data likely represent the minimum risks.

Developing Repair Materials for Stress Urinary Incontinence to Withstand Dynamic Distension. Abstract Background Polypropylene mesh used as a mid-urethral sling is associated with severe clinical complications in a significant minority of patients.

Developing Repair Materials for Stress Urinary Incontinence to Withstand Dynamic Distension

Current in vitro mechanical testing shows that polypropylene responds inadequately to mechanical distension and is also poor at supporting cell proliferation. Official figures show the true complication rate of #mesh in England is 8.56% not 1-3% as quoted in NHS literature. Alles over gezondheid binnen handbereik. Screen-Shot-2016-01-15-at-8.44.26-AM. Epsiode statistics Rev4. Urogynecology Expert Witness Links Woman’s Continuing Pain to Defective Transvaginal Mesh. In this case, a urogynecologic surgery expert evaluates injuries to the plaintiff that were allegedly caused by an improperly designed and manufactured pelvic mesh implant.

Urogynecology Expert Witness Links Woman’s Continuing Pain to Defective Transvaginal Mesh

Plaintiff suffered from a vaginal bulge with falling out symptoms, pain and pelvic pressure and symptoms of stress urinary incontinence, along with menopausal symptoms. She was diagnosed with a bladder hernia into the vagina and a rectal hernia into the vagina. She underwent surgery, in which a biosynthetic support system using polypropylene mesh manufactured by defendants was implanted. Within a year, plaintiff was treated for polypropylene erosion.

She was observed several times with erosion of the mesh, and was also was treated for a tight sling. Plaintiff currently suffers from pain in the back, stomach, pelvis, rectum and legs, as well as ongoing urinary incontinence. Question(s) For Expert Witness 1.) Expert Witness Response Working on a similar case? It only takes 30-seconds to get started. Post Tags. Mesh Complications & Surgery. Background, Symptoms, and Causes The majority of patients who undergo mesh surgery for urinary incontinence and pelvic organ prolapse have successful outcomes.

Mesh Complications & Surgery

However, serious complications occur in up to 5% of cases and minor complications occur in 20% or more. The reconstructive surgeons at UroCenter of New York are among the most experienced in the world at treating these complications. Combined they’ve done hundreds, and Dr. Article33009014.pdf. Complications of synthetic mid-urethral slings. C.

Complications of synthetic mid-urethral slings

Twiss, S. Raz Christian O. Twiss, MD, received his MD from New York University School of Medicine, in New York, New York. He is finishing a fellowship in female urology, reconstructive surgery, and urodynamics at the University of California, Los Angeles and will be joining the faculty at the University of Arizona, Division of Urology as an assistant professor and director of female urology and urodynamics. Due to its efficacy, safety, and relative simplicity, the synthetic mid-urethral sling procedure has emerged as one of the mainstays of surgical therapy for female stress urinary incontinence. BleedingOne of the difficulties in assessing bleeding complications of synthetic sling placement is that “bleeding” as a complication has no firm definition or criteria.

More recent evidence suggests that bleeding is significantly reduced with the transobturator approach to mid-urethral sling placement. Postoperative vaginal erosions are another problem with synthetic slings. Complications of synthetic slings used in female stress urinary incontinence and applicability of the new IUGA-ICS classification. Safety considerations for synthetic sling surgery : Nature Reviews Urology. Implantation of a synthetic midurethral sling (SMUS) is the most commonly performed anti-incontinence operation in women worldwide.

Safety considerations for synthetic sling surgery : Nature Reviews Urology

The effectiveness of the SMUS is comparable to that of the historical gold standards—autologous fascial slings and the Burch colposuspension. Mesh Sling in an Era of Uncertainty_ Lessons Learned and the Way Forward. Despite warnings, mesh use for prolapse on the rise. Despite the FDA’s warnings about health risks associated with the use of surgical mesh for transvaginal repair of pelvic organ prolapse (POP), use of the device is increasing, according to a study of POP patients in New York state. Read: Statins delay PCa progression in patients on ADT At the same time, risks of reinterventions within 1 year and post-surgery urinary retention continue, said the authors of the study, which was published online in BMJ (June 2, 2015). Researchers at Weill Medical College of Cornell University in New York analyzed a statewide database of nearly 28,000 women who had prolapse repair procedures in the state from 2008 to 2011.

More than 7,300 women underwent prolapse repair with mesh and 20,653 had the procedure without mesh. Acute In Vivo Response to an Alternative Implant for Urogynecology. Safety considerations for synthetic sling surgery. 000011.pdf. Editorial - What is the role of mid-urethral slings in the management of stress incontinence in women?

Urinary incontinence is very common in women: about 40% have persistent urinary incontinence after childbirth.[1] Urine leakage can affect quality of life, including social activities, work, psychological wellbeing, and sexual relationships. Women with stress urinary incontinence (leakage when they cough, laugh, or exercise) normally try pelvic floor exercises in the first instance. If this fails, more women than ever before are seeking a surgical cure.