Postoperative Pain After Adjustable Single-Incision or Transobturator Sling for Incontinence: A Randomized Controlled Trial. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Schweitzer, Karlijn J.; Milani, Alfredo L.; van Eijndhoven, Hugo W.F.; Gietelink, Dirk A.; Hallensleben, Eric; Cromheecke, Geert-Jan; van der Vaart, Carl H.
• Is Part Of: Obstetrics and gynecology. Volume 125:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/AOG.0000000000000604
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : OBJECTIVE: To compare postoperative pain scores and assess efficacy between an adjustable single-incision sling and a standard transobturator sling for stress urinary incontinence (SUI). METHODS: This single-blinded randomized controlled trial involved 156 women with clinically proven SUI. Women were allocated to receive either an adjustable single-incision or a transobturator sling. The primary outcome was postoperative pain score on a visual analog scale. Secondary outcomes were objective and subjective cure rates at 12 months, symptom bother scores, quality of life, and complications. RESULTS: The mean pain score in the first week postoperatively was significantly lower at all time points in the adjustable single-incision sling group compared with the transobturator sling group. Maximum difference in pain score was reported on the evening of the day of surgery; median pain score was 1.0 (interquartile range 2.0) in the adjustable sling group and 3.0 (interquartile range 4.5) in the transobturator sling group (Mann Whitney U test P <.001). There was no statistical difference in analgesic use. The objective cure rates in the adjustable single-incision sling and in the transobturator sling group were 90.8% and 88.6% ( P =.760), and the subjective cure rates were 77.2% and 72.9% ( P =.577), respectively. No difference in the complication rate was found. CONCLUSION: An adjustable single-incision sling for the treatment of SUI is associated with lower early postoperative pain scores but shows comparable cure rates with a transobturator at 12 months of follow-up. CLINICAL TRIAL REGISTRATION: Netherlands Trial Register, http://www.trialregister.nl, NTR: 2558. LEVEL OF EVIDENCE: I Abstract : An adjustable single-incision sling is associated with lower postoperative pain scores in the short term than is a transobturator sling with comparable effectiveness.