title: Transobturator SAFYRE sling is as effective as the transvaginal procedure.
abstract: BACKGROUND
  SAFYRE is a monofilament polypropylene mesh held between two self-anchoring silicone columns that associates universal approach with readjustability. This unique feature allows for comparing two different approaches, i.e., transvaginal and transobturator, using the same sling.
  
  
  METHODS
  A total of 226 patients with clinical and urodynamic diagnosis of SUI underwent SAFYRE sling procedure, which was performed either by transvaginal (group 1; 126 patients) or transobturator approach (group 2; 100 patients). The mean age was 63 years, in group 1 and 61 years in group 2. Physical examination, stress and pad test and urodynamic assessment were performed before the surgery.
  
  
  RESULTS
  The average follow-up period was 18 months in group 1 and 14 months in group 2. There was no difference in cure rate in both groups. The mean operative time was longer (25 min) in group 1 than in group 2 (15 min) (P<0.05). Bladder injury was significative greater in transvaginal group [respectively, 12/126 (0%) versus 0/100 (0%)]. Postoperatively, 20.6% of the patients presented transient irritative voiding symptoms in group transvaginal group as opposed to 10% in transobturator group.
  
  
  CONCLUSIONS
  SAFYRE sling performed by transobturator approach is as effective as the transvaginal procedure. Fewer complications and less operative time were additional advantages of the transobturator approach.
authors.affiliation: Division of Urology and Gynecology, Universidade Estadual de Campinas--UNICAMP Campinas- Brazil, Rua Jose Pugliesi Filho 265 CEP, 13085032 Campinas, Brazil. ppalma@uol.com.br
authors.forename: Paulo
authors.initials: P
authors.lastname: Palma
authors.forename: Cassio
authors.initials: C
authors.lastname: Riccetto
authors.forename: Viviane
authors.initials: V
authors.lastname: Herrmann
authors.forename: Miriam
authors.initials: M
authors.lastname: Dambros
authors.forename: Marcelo
authors.initials: M
authors.lastname: Thiel
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Bandiera
authors.forename: Nelson Rodrigues
authors.initials: NR
authors.lastname: Netto
mesh_terms: D000368:Aged; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes; D019736:Prostheses and Implants; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
chemical_list: D011126:Polypropylenes