Transobturator SAFYRE sling is as effective as the transvaginal procedure.
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.
Palma
Paulo
P
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
Riccetto
Cassio
C
Herrmann
Viviane
V
Dambros
Miriam
M
Thiel
Marcelo
M
Bandiera
Sebastiano
S
Netto
Nelson Rodrigues
NR
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*
D011126:Polypropylenes